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Miranda-Mendizabal A, Castellví P, Vilagut G, Alayo I, Almenara J, Ballester L, Echeburúa E, Gabilondo A, Gili M, Mortier P, Piqueras JA, Roca M, Auerbach RP, Bruffaerts R, Kessler RC, Alonso Caballero J. Suicidal ideation risk among LGB Spanish university students: The role of childhood and adolescence adversities and mental disorders. J Affect Disord 2024; 353:52-59. [PMID: 38417714 DOI: 10.1016/j.jad.2024.02.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Childhood/adolescence adversities and mental disorders are higher among LGB youths. AIMS To evaluate the role of childhood maltreatment, bullying, and mental disorders on the association between sexual orientation and suicidal ideation (SI); and the role of mental disorders on the association between sexual orientation discrimination and SI. METHODS Baseline and 12-month follow-up online surveys of Spanish first-year university students (18-24-year-olds). Multivariable logistic regression models assessed the effects of childhood/adolescence adversities and mental disorders in the relationship between sexual orientation, discrimination and SI. RESULTS A total of 1224 students were included (16.4 % LGBs). Risk factors of lifetime SI were sexual orientation (OR 2.4), any bullying (OR 2.4), any childhood maltreatment (OR 4.0), and any mental disorders (OR 3.8). Final model Area Under the Curve (AUC) 0.78. Among homosexual and bisexual students, discrimination showed increased risk of 12-month SI (OR 2.2), but this effect was no longer statistically significant when any 12-month mental disorder was added (OR 7.8). Final model AUC 0.72. LIMITATIONS Sample of interest was relatively small. But it was similar to comparable studies and statistical adjustments have been performed. Assessment of mental disorders and SI was not based on clinical assessment. However, validated scales showing good diagnostic agreement with clinical judgement were used. CONCLUSIONS Childhood/adolescence adversities and mental disorders interact in the association between sexual orientation and SI. Mental disorders may mediate the association between sexual orientation discrimination and SI. Further research using larger samples and causal modelling approach assessing the mediators of SI risk among LGBs is needed.
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Affiliation(s)
- Andrea Miranda-Mendizabal
- Teaching, Research & Innovation Unit, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Spain; Mental Health Networking Biomedical Research Centre (CIBERSAM), Madrid, Spain; Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.
| | - Pere Castellví
- Department of Medicine, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Itxaso Alayo
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; Carrer Dr. Antoni Pujadas 42, 08830 Sant Boi de Llobregar, Spain; Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | | | - Laura Ballester
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Andrea Gabilondo
- Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, Biodonosti Health Research Institute, San Sebastian, Spain
| | - Margalida Gili
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Philippe Mortier
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - José Antonio Piqueras
- Department of Health Psychology, Miguel Hernández University of Elche (UMH), Alicante, Spain
| | - Miquel Roca
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Randy P Auerbach
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum, KU Leuven (UPC-KUL), Leuven, Belgium
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Jordi Alonso Caballero
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain.
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2
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Pagliaccio D, Bitran A, Kirshenbaum JS, Alqueza KL, Durham K, Chernick LS, Joyce K, Lan R, Porta G, Brent DA, Allen NB, Auerbach RP. Testing the interpersonal theory of suicide in adolescents: A multi-wave longitudinal study. J Child Psychol Psychiatry 2024; 65:668-679. [PMID: 37474206 PMCID: PMC10799188 DOI: 10.1111/jcpp.13868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/19/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Suicide is a major public health crisis among youth. Several prominent theories, including the Interpersonal Theory of Suicide (IPTS), aim to characterize the factors leading from suicide ideation to action. These theories are largely based on findings in adults and require testing and elaboration in adolescents. METHODS Data were examined from high-risk 13-18-year-old adolescents (N = 167) participating in a multi-wave, longitudinal study; 63% of the sample exhibited current suicidal thoughts or recent behaviors (n = 105). The study included a 6-month follow-up period with clinical interviews and self-report measures at each of the four assessments as well as weekly smartphone-based assessments of suicidal thoughts and behaviors. Regression and structural equation models were used to probe hypotheses related to the core tenets of the IPTS. RESULTS Feelings of perceived burdensomeness were associated with more severe self-reported suicidal ideation (b = 0.58, t(158) = 7.64, p < .001). Similarly, burdensomeness was associated with more frequent ideation based on weekly smartphone ratings (b = 0.11, t(1460) = 3.41, p < .001). Contrary to IPTS hypotheses, neither feelings of thwarted belongingness, nor interactions between burdensomeness and thwarted belongingness were significantly associated with ideation (ps > .05). Only elevated depression severity was associated with greater odds of suicide events (i.e., suicide attempts, psychiatric hospitalizations, and/or emergency department visits for suicide concerns) during the follow-up period (OR = 1.83, t(158) = 2.44, p = .01). No effect of acquired capability was found. CONCLUSIONS Perceptions of burdensomeness to others reflect a critical risk factor for suicidal ideation among high-risk adolescents. Null findings with other IPTS constructs may suggest a need to adopt more developmentally sensitive models or measures of interpersonal and acquired capability risk factors for youth. Refining methods and theoretical models of suicide risk may help improve the identification of high-risk cases and inform clinical intervention.
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Affiliation(s)
- David Pagliaccio
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | - Alma Bitran
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | - Jaclyn S. Kirshenbaum
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | - Kira L. Alqueza
- School of Special Education, School Psychology, and Early Childhood Studies, University of Florida, Gainesville, FL
| | - Katherine Durham
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | - Lauren S. Chernick
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY
| | - Karla Joyce
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ranqing Lan
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | - Giovanna Porta
- UPMC Western Psychiatric Hospital, Pittsburgh, Pennsylvania
| | - David A. Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Randy P. Auerbach
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
- Sackler Institute for Developmental Psychobiology at Columbia University, New York, NY, USA
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3
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Letkiewicz AM, Funkhouser CJ, Umemoto A, Trivedi E, Sritharan A, Zhang E, Buchanan SN, Helgren F, Allison GO, Kayser J, Shankman SA, Auerbach RP. Neurophysiological responses to emotional faces predict dynamic fluctuations in affect in adolescents. Psychophysiology 2024; 61:e14476. [PMID: 37905333 PMCID: PMC10939961 DOI: 10.1111/psyp.14476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 08/09/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023]
Abstract
The ability to accurately identify and interpret others' emotions is critical for social and emotional functioning during adolescence. Indeed, previous research has identified that laboratory-based indices of facial emotion recognition and engagement with emotional faces predict adolescent mood states. Whether socioemotional information processing relates to real-world affective dynamics using an ecologically sensitive approach, however, has rarely been assessed. In the present study, adolescents (N = 62; ages 13-18) completed a Facial Recognition Task, including happy, angry, and sad stimuli, while EEG data were acquired. Participants also provided ecological momentary assessment (EMA) data probing their current level of happiness, anger, and sadness for 1-week, resulting in indices of emotion (mean-level, inertia, instability). Analyses focused on relations between (1) accuracy for and (2) prolonged engagement with (LPP) emotional faces and EMA-reported emotions. Greater prolonged engagement with happy faces was related to less resistance to changes in happiness (i.e., less happiness inertia), whereas greater prolonged engagement with angry faces associated with more resistance to changes in anger (i.e., greater anger inertia). Results suggest that socioemotional processes captured by laboratory measures have real-world implications for adolescent affective states and highlight potentially actionable targets for novel treatment approaches (e.g., just-in-time interventions). Future studies should continue to assess relations among socioemotional informational processes and dynamic fluctuations in adolescent affective states.
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Affiliation(s)
- Allison M. Letkiewicz
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Carter J. Funkhouser
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York, NY, USA
| | - Akina Umemoto
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York, NY, USA
- Department of Psychology, Montclair State University, Montclair, NJ, USA
| | - Esha Trivedi
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York, NY, USA
| | - Aishwarya Sritharan
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York, NY, USA
| | - Emily Zhang
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York, NY, USA
| | - Savannah N. Buchanan
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Fiona Helgren
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Grace O. Allison
- Department of Psychology, McGill University, Montreal, Quebec, CA
| | - Jürgen Kayser
- Department of Psychiatry, Columbia University, New York, NY, USA
- Translational Epidemiology, New York State Psychiatric Institute, New York, NY, USA
| | - Stewart A. Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York, NY, USA
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Hasking PA, Robinson K, McEvoy P, Melvin G, Bruffaerts R, Boyes ME, Auerbach RP, Hendrie D, Nock MK, Preece DA, Rees C, Kessler RC. Development and evaluation of a predictive algorithm and telehealth intervention to reduce suicidal behavior among university students. Psychol Med 2024; 54:971-979. [PMID: 37732419 PMCID: PMC10939946 DOI: 10.1017/s0033291723002714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
BACKGROUND Suicidal behaviors are prevalent among college students; however, students remain reluctant to seek support. We developed a predictive algorithm to identify students at risk of suicidal behavior and used telehealth to reduce subsequent risk. METHODS Data come from several waves of a prospective cohort study (2016-2022) of college students (n = 5454). All first-year students were invited to participate as volunteers. (Response rates range: 16.00-19.93%). A stepped-care approach was implemented: (i) all students received a comprehensive list of services; (ii) those reporting past 12-month suicidal ideation were directed to a safety planning application; (iii) those identified as high risk of suicidal behavior by the algorithm or reporting 12-month suicide attempt were contacted via telephone within 24-h of survey completion. Intervention focused on support/safety-planning, and referral to services for this high-risk group. RESULTS 5454 students ranging in age from 17-36 (s.d. = 5.346) participated; 65% female. The algorithm identified 77% of students reporting subsequent suicidal behavior in the top 15% of predicted probabilities (Sensitivity = 26.26 [95% CI 17.93-36.07]; Specificity = 97.46 [95% CI 96.21-98.38], PPV = 53.06 [95% CI 40.16-65.56]; AUC range: 0.895 [95% CIs 0.872-0.917] to 0.966 [95% CIs 0.939-0.994]). High-risk students in the Intervention Cohort showed a 41.7% reduction in probability of suicidal behavior at 12-month follow-up compared to high-risk students in the Control Cohort. CONCLUSIONS Predictive risk algorithms embedded into universal screening, coupled with telehealth intervention, offer significant potential as a suicide prevention approach for students.
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Affiliation(s)
- Penelope A Hasking
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Faculty of Health Sciences, enAble Institute, Curtin University, Perth, Australia
| | - Kealagh Robinson
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Faculty of Health Sciences, enAble Institute, Curtin University, Perth, Australia
| | - Peter McEvoy
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Faculty of Health Sciences, enAble Institute, Curtin University, Perth, Australia
- Centre for Clinical Interventions, Perth, Australia
| | - Glenn Melvin
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
| | | | - Mark E Boyes
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Faculty of Health Sciences, enAble Institute, Curtin University, Perth, Australia
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, USA
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, USA
| | - Delia Hendrie
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, USA
| | - David A Preece
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Faculty of Health Sciences, enAble Institute, Curtin University, Perth, Australia
| | - Clare Rees
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, USA
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Gu SJ, Aimufua I, Pagliaccio D, Shankman SA, Steinglass JE, Auerbach RP, Walsh BT, Ranzenhofer LM. Self-referential processing in anorexia nervosa. Int J Eat Disord 2024. [PMID: 38436447 DOI: 10.1002/eat.24176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE Anorexia nervosa (AN) is a serious psychiatric illness associated with significant medical and psychiatric comorbidity and impairment. Theoretical models of AN and self-report studies suggest that negative self-evaluation (i.e., low self-esteem) is related to the development and maintenance of AN. The goal of this study was to extend findings from self-report methodology using a neurocognitive task that probes self-evaluation implicitly and explicitly. METHOD We compared female adolescent and adult patients with AN (n = 35) and healthy controls (HC, n = 38) on explicit (i.e., endorsement of words as self-relevant), implicit (recall, recognition, reaction time), and composite (i.e., valence index, bias score, drift rates) indices of self-evaluation. We applied a drift-diffusion model to compute the drift rates, reflecting participants' decision-making process as to whether words were self-relevant. The association between self-evaluation indices and eating disorder severity was examined. RESULTS There were significant Group × Condition interaction effects for all explicit and implicit measures (all p's ≤ .01), where the AN group endorsed, recalled, and recognized more negative relative to positive words than HC. The AN group had more negative valence index and bias scores, and slower drift rate away from negative words, reflecting more negative self-evaluation. The finding for recall was attenuated when individuals with depression were excluded. Measures of self-evaluation bias were not related to eating disorder severity. DISCUSSION Using a neurocognitive approach that includes explicit and implicit indices of bias, results suggest that patients with AN have more negative self-evaluation. Due to the cross-sectional design, additional studies are needed to further evaluate directionality. PUBLIC SIGNIFICANCE Negative self-evaluation/low self-esteem is thought to contribute to eating disorder symptoms. Findings of this study using a neurocognitive task to probe self-evaluation suggested that individuals with anorexia nervosa have more negative self-evaluation, reflected by endorsing and remembering more negative (than positive) words compared to healthy controls, and doing so faster. Targeting the construct of negative self-evaluation in treatment of AN may be warranted.
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Affiliation(s)
- Serena J Gu
- New York State Psychiatric Institute, New York, New York, USA
| | - Ivieosa Aimufua
- New York State Psychiatric Institute, New York, New York, USA
| | - David Pagliaccio
- New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Stewart A Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, Illinois, USA
| | - Joanna E Steinglass
- New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Randy P Auerbach
- New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - B Timothy Walsh
- New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Lisa M Ranzenhofer
- New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
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Kirshenbaum JS, Pagliaccio D, Pizzagalli DA, Auerbach RP. Neural sensitivity following stress predicts anhedonia symptoms: a 2-year multi-wave, longitudinal study. Transl Psychiatry 2024; 14:106. [PMID: 38388454 PMCID: PMC10884408 DOI: 10.1038/s41398-024-02818-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
Animal models of depression show that acute stress negatively impacts functioning in neural regions sensitive to reward and punishment, often manifesting as anhedonic behaviors. However, few human studies have probed stress-induced neural activation changes in relation to anhedonia, which is critical for clarifying risk for affective disorders. Participants (N = 85, 12-14 years-old, 53 female), oversampled for risk of depression, were administered clinical assessments and completed an fMRI guessing task during a baseline (no-stress) period to probe neural response to receipt of rewards and losses. After the initial task run of the fMRI guessing task, participants received an acute stressor and then, were re-administered the guessing task. Including baseline, participants provided up to 10 self-report assessments of life stress and symptoms over a 2 year period. Linear mixed-effects models estimated whether change in neural activation (post- vs. pre-acute stressor) moderated the longitudinal associations between life stress and symptoms. Primary analyses indicated that adolescents with stress-related reductions in right ventral striatum response to rewards exhibited stronger longitudinal associations between life stress and anhedonia severity (β = -0.06, 95%CI[-0.11, -0.02], p = 0.008, pFDR = 0.048). Secondary analyses showed that longitudinal positive associations between life stress and depression severity were moderated by stress-related increases in dorsal striatum response to rewards (left caudate β = 0.11, 95%CI[0.07,0.17], p < 0.001, pFDR = 0.002; right caudate β = 0.07, 95%CI[0.02,0.12], p = 0.002, pFDR = 0.003; left putamen β = 0.09, 95%CI[0.04, 0.14], p < 0.001, pFDR = 0.002; right putamen β = 0.08, 95%CI[0.03, 0.12], p < 0.001, pFDR = 0.002). Additionally, longitudinal positive associations among life stress and anxiety severity were moderated by stress-related reductions in dorsal anterior cingulate cortex (β = -0.07, 95%CI[-0.12,.02], p = 0.008, pFDR = 0.012) and right anterior insula (β = -0.07, 95%CI[-0.12,-0.02], p = 0.002, pFDR = 0.006) response to loss. All results held when adjusting for comorbid symptoms. Results show convergence with animal models, highlighting mechanisms that may facilitate stress-induced anhedonia as well as a separable pathway for the emergence of depressive and anxiety symptoms.
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Affiliation(s)
- Jaclyn S Kirshenbaum
- Department of Psychiatry, Columbia University, New York, NY, USA.
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA.
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Diego A Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA
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7
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Millon EM, Alqueza KL, Kamath RA, Marsh R, Pagliaccio D, Blumberg HP, Stewart JG, Auerbach RP. Non-suicidal Self-injurious Thoughts and Behaviors Among Adolescent Inpatients. Child Psychiatry Hum Dev 2024; 55:48-59. [PMID: 35727385 PMCID: PMC9782727 DOI: 10.1007/s10578-022-01380-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/19/2022] [Indexed: 01/07/2023]
Abstract
Non-suicidal self-injury (NSSI) is a serious public health concern that typically onsets during early adolescence. Adolescents (N = 980, ages 12-19 years) admitted for acute, residential psychiatric treatment completed baseline clinical interviews assessing mental disorders and questionnaires measuring demographics, early life adversity, and symptom severity. Prevalence rates of NSSI for lifetime (thoughts: 78%; behaviors: 72%), past year (thoughts: 74%; behaviors: 65%), and past month (thoughts: 68%; behaviors: 51%) were high. Although effect sizes were modest, the presence of a lifetime depressive disorder, sexual abuse, and comorbidity (i.e., three or more current disorders) were significant correlates of experiencing NSSI thoughts and behaviors. Furthermore, lifetime depressive disorder, current anxiety disorder, and comorbidity were associated with a greater odds of persistent NSSI thoughts and/or behaviors. Longitudinal studies are needed to determine whether targeting these factors reduces the persistence of NSSI thoughts and behaviors.
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Affiliation(s)
- Emma M Millon
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Kira L Alqueza
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Rahil A Kamath
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Rachel Marsh
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jeremy G Stewart
- Department of Psychology and Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA.
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA.
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA.
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8
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Gao Y, Panier LYX, Gameroff MJ, Auerbach RP, Posner J, Weissman MM, Kayser J. Feedback negativity and feedback-related P3 in individuals at risk for depression: Comparing surface potentials and current source densities. Psychophysiology 2024; 61:e14444. [PMID: 37740325 DOI: 10.1111/psyp.14444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 09/24/2023]
Abstract
Blunted responses to reward feedback have been linked to major depressive disorder (MDD) and depression risk. Using a monetary incentive delay task (win, loss, break-even), we investigated the impact of family risk for depression and lifetime history of MDD and anxiety disorder with 72-channel electroencephalograms (EEG) recorded from 29 high-risk and 32 low-risk individuals (15-58 years, 30 male). Linked-mastoid surface potentials (ERPs) and their corresponding reference-free current source densities (CSDs) were quantified by temporal principal components analysis (PCA). Each PCA solution revealed a midfrontal feedback negativity (FN; peak around 310 ms) and a posterior feedback-P3 (fb-P3; 380 ms) as two distinct reward processing stages. Unbiased permutation tests and multilevel modeling of component scores revealed greater FN to loss than win and neutral for all stratification groups, confirming FN sensitivity to valence. Likewise, all groups had greater fb-P3 to win and loss than neutral, confirming that fb-P3 indexes motivational salience and allocation of attention. By contrast, group effects were subtle, dependent on data transformation (ERP, CSD), and did not confirm reduced FN or fb-P3 for at-risk individuals. Instead, CSD-based fb-P3 was overall reduced in individuals with than without MDD history, whereas ERP-based fb-P3 was greater for high-risk individuals than for low-risk individuals for monetary, but not neutral outcomes. While the present findings do not support blunted reward processing in depression and depression risk, our side-by-side comparison underscores how the EEG reference choice affects the characterization of subtle group differences, strongly advocating the use of reference-free techniques.
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Affiliation(s)
- Yifan Gao
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York, USA
| | - Lidia Y X Panier
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York, USA
| | - Marc J Gameroff
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York, USA
| | - Randy P Auerbach
- Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York, USA
| | - Jonathan Posner
- Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York, USA
| | - Myrna M Weissman
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York, USA
| | - Jürgen Kayser
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York, USA
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9
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Stewart JG, Pizzagalli DA, Auerbach RP. Stress exposure in at-risk, depressed, and suicidal adolescents. J Child Psychol Psychiatry 2023. [PMID: 38100210 DOI: 10.1111/jcpp.13935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Stress exposure contributes to the onset, maintenance, and recurrence of major depressive disorder (MDD) in adolescents. However, the precise stress facets (e.g. chronicity, domain) most strongly linked to outcomes at different stages along the depression severity continuum remain unclear. Across two studies, chronic and episodic stressors were comprehensively assessed among: (a) healthy youth with (High-Risk [HR]) and without (Low-Risk [LR]) a maternal history of MDD and (b) adolescents with current MDD and suicide ideation and healthy controls (HC). METHOD Study 1 included LR (n = 65) and HR (n = 22) 12- to 14-year-olds (49 females; 56.32%) with no lifetime history of mental disorders. Study 2 enrolled 87 mid-to-late adolescents (64 females; 73.56%), including 57 MDD youth from a short-term intensive treatment service and 30 HCs from the community. All depressed youth reported recent suicide ideation; some had no lifetime history suicide attempts (SI; n = 31) and others reported at least one past year attempt (SA; n = 26). The Life Events and Difficulties Schedule was used to capture stressor severity in both studies. RESULTS We used multiple linear regression models that adjusted for demographic and clinical covariates. Being in the HR versus LR group was associated with more severe chronic (β = .22, CI95 = 0.01-0.42, p = .041), independent (β = .34, CI95 = 0.12-0.56, p = .003), and interpersonal (β = .23, CI95 = 0.004-0.45, p = .047) stress severity. By contrast, the MDD group reported significantly more severe chronic (β = .62, CI95 = 0.45-0.79, p < .001) and dependent (β = .41, CI95 = 0.21-0.61, p < .001) stress than the HC group, but not independent (p = .083) stress. Stress severity did not differ between recent attempters versus youth who reported suicide ideation alone (SA vs. SI contrast). However, the SA group reported a higher rate of targeted rejection events (RR = 3.53, CI95 = 1.17-10.70, p = .026). CONCLUSIONS Our findings clarify the stressor features that may most strongly contribute to adolescent depression and its clinical correlates at two important points along depression's clinical course.
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Affiliation(s)
- Jeremy G Stewart
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Diego A Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
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10
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Munthali RJ, Richardson CG, Pei J, Westenberg JN, Munro L, Auerbach RP, Prescivalli AP, Vereschagin M, Clarke QK, Wang AY, Vigo D. Patterns of anxiety, depression, and substance use risk behaviors among university students in Canada. J Am Coll Health 2023:1-11. [PMID: 37943497 DOI: 10.1080/07448481.2023.2277201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/22/2023] [Indexed: 11/10/2023]
Abstract
Objective: To identify subgroups of students with distinct profiles of mental health symptoms (MH) and substance use risk (SU) and the extent to which MH history and socio-demographics predict subgroup membership. Participants: University students (N = 10,935: 63% female). Methods: Repeated cross-sectional survey administered weekly to stratified random samples. Latent class analysis (LCA) was used to identify subgroups and multinomial regression was used to examine associations with variables of interest. Results: LCA identified an optimal 4-latent class solution: High MH-Low SU (47%), Low MH-Low SU (22%), High MH-High SU (19%), and Low MH-High SU (12%). MH history, gender, and ethnicity were associated with membership in the classes with high risk of MH, SU, or both. Conclusion: A substantial proportion of students presented with MH, SU, or both. Gender, ethnicity and MH history is associated with specific patterns of MH and SU, offering potentially useful information to tailor early interventions.
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Affiliation(s)
- Richard J Munthali
- Department of Psychiatry, University of British Columbia, British Columbia, Canada
| | - Chris G Richardson
- School of Population and Public Health, University of British Columbia, British Columbia, Canada
| | - Julia Pei
- Department of Psychiatry, University of British Columbia, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, British Columbia, Canada
| | - Jean N Westenberg
- Department of Psychiatry, University of British Columbia, British Columbia, Canada
| | - Lonna Munro
- Department of Psychiatry, University of British Columbia, British Columbia, Canada
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, New York, USA
| | | | - Melissa Vereschagin
- Department of Psychiatry, University of British Columbia, British Columbia, Canada
| | - Quinten K Clarke
- Department of Psychiatry, University of British Columbia, British Columbia, Canada
| | - Angel Y Wang
- Department of Psychiatry, University of British Columbia, British Columbia, Canada
| | - Daniel Vigo
- Department of Psychiatry, University of British Columbia, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, British Columbia, Canada
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11
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Li LY, Trivedi E, Helgren F, Allison GO, Zhang E, Buchanan SN, Pagliaccio D, Durham K, Allen NB, Auerbach RP, Shankman SA. Capturing mood dynamics through adolescent smartphone social communication. J Psychopathol Clin Sci 2023; 132:1072-1084. [PMID: 37498714 PMCID: PMC10818010 DOI: 10.1037/abn0000855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Most adolescents with depression remain undiagnosed and untreated-missed opportunities that are costly from both personal and public health perspectives. A promising approach to detecting adolescent depression in real-time and at a large scale is through their social communication on the smartphone (e.g., text messages, social media posts). Past research has shown that language from online social communication reliably indicates interindividual differences in depression. To move toward detecting the emergence of depression symptoms intraindividually, the present study tested whether sentiment (i.e., words connoting positive and negative affect) from smartphone social communication prospectively predicted daily mood fluctuations in 83 adolescents (Mage = 16.49, 73.5% female) with a wide range of depression severity. Participants completed daily mood ratings across a 90-day period, during which 354,278 messages were passively collected from social communication apps. Greater positive sentiment (i.e., more positive weighted composite valence score and a greater proportion of words expressing positive sentiment) predicted more positive next-day mood, controlling for previous-day mood. Moreover, greater proportions of positive and negative sentiment were, respectively, associated with lower anhedonia and greater dysphoria symptoms measured at baseline. Exploratory analyses of nonaffective linguistic features showed that greater use of social engagement words (e.g., friends and affiliation) and emojis (primarily consisting of hearts) predicted more positive changes in mood. Collectively, findings suggest that language from smartphone social communication can detect mood fluctuations in adolescents, laying the foundation for language-based tools to identify periods of heightened depression risk. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Lilian Y. Li
- Department of Psychiatry and Behavioral Sciences, Northwestern University
| | - Esha Trivedi
- Department of Psychiatry, Columbia University
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute
| | - Fiona Helgren
- Department of Psychiatry and Behavioral Sciences, Northwestern University
| | | | - Emily Zhang
- Department of Psychiatry, Columbia University
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute
| | | | - David Pagliaccio
- Department of Psychiatry, Columbia University
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute
| | - Katherine Durham
- Department of Psychiatry, Columbia University
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute
| | | | - Randy P. Auerbach
- Department of Psychiatry, Columbia University
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute
- Division of Clinical Developmental Neuroscience, Sackler Institute
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12
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Bloom PA, Pagliaccio D, Zhang J, Bauer CCC, Kyler M, Greene KD, Treves I, Morfini F, Durham K, Cherner R, Bajwa Z, Wool E, Olafsson V, Lee RF, Bidmead F, Cardona J, Kirshenbaum JS, Ghosh S, Hinds O, Wighton P, Galfalvy H, Simpson HB, Whitfield-Gabrieli S, Auerbach RP. Mindfulness-based real-time fMRI neurofeedback: a randomized controlled trial to optimize dosing for depressed adolescents. BMC Psychiatry 2023; 23:757. [PMID: 37848857 PMCID: PMC10580563 DOI: 10.1186/s12888-023-05223-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Adolescence is characterized by a heightened vulnerability for Major Depressive Disorder (MDD) onset, and currently, treatments are only effective for roughly half of adolescents with MDD. Accordingly, novel interventions are urgently needed. This study aims to establish mindfulness-based real-time fMRI neurofeedback (mbNF) as a non-invasive approach to downregulate the default mode network (DMN) in order to decrease ruminatory processes and depressive symptoms. METHODS Adolescents (N = 90) with a current diagnosis of MDD ages 13-18-years-old will be randomized in a parallel group, two-arm, superiority trial to receive either 15 or 30 min of mbNF with a 1:1 allocation ratio. Real-time neurofeedback based on activation of the frontoparietal network (FPN) relative to the DMN will be displayed to participants via the movement of a ball on a computer screen while participants practice mindfulness in the scanner. We hypothesize that within-DMN (medial prefrontal cortex [mPFC] with posterior cingulate cortex [PCC]) functional connectivity will be reduced following mbNF (Aim 1: Target Engagement). Additionally, we hypothesize that participants in the 30-min mbNF condition will show greater reductions in within-DMN functional connectivity (Aim 2: Dosing Impact on Target Engagement). Aim 1 will analyze data from all participants as a single-group, and Aim 2 will leverage the randomized assignment to analyze data as a parallel-group trial. Secondary analyses will probe changes in depressive symptoms and rumination. DISCUSSION Results of this study will determine whether mbNF reduces functional connectivity within the DMN among adolescents with MDD, and critically, will identify the optimal dosing with respect to DMN modulation as well as reduction in depressive symptoms and rumination. TRIAL REGISTRATION This study has been registered with clinicaltrials.gov, most recently updated on July 6, 2023 (trial identifier: NCT05617495).
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Affiliation(s)
- Paul A Bloom
- Department of Psychiatry, Columbia University, New York, NY, USA.
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Jiahe Zhang
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Clemens C C Bauer
- Department of Psychology, Northeastern University, Boston, MA, USA
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Mia Kyler
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Keara D Greene
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Isaac Treves
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | - Katherine Durham
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Rachel Cherner
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Zia Bajwa
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Emma Wool
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Valur Olafsson
- Northeastern University Biomedical Imaging Center, Boston, MA, USA
| | - Ray F Lee
- Zuckerman Mind Brain and Behavior Institute, Columbia University, New York, NY, USA
| | - Fred Bidmead
- Northeastern University Biomedical Imaging Center, Boston, MA, USA
| | - Jonathan Cardona
- Zuckerman Mind Brain and Behavior Institute, Columbia University, New York, NY, USA
| | | | | | | | - Paul Wighton
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Hanga Galfalvy
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - H Blair Simpson
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Susan Whitfield-Gabrieli
- Department of Psychology, Northeastern University, Boston, MA, USA
- Northeastern University Biomedical Imaging Center, Boston, MA, USA
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA
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13
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Liu C, Belleau EL, Dong D, Sun X, Xiong G, Pizzagalli DA, Auerbach RP, Wang X, Yao S. Trait- and state-like co-activation pattern dynamics in current and remitted major depressive disorder. J Affect Disord 2023; 337:159-168. [PMID: 37245549 PMCID: PMC10897955 DOI: 10.1016/j.jad.2023.05.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 05/02/2023] [Accepted: 05/21/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Distinguishing between trait- and state-like neural alternations in major depressive disorder (MDD) may advance our understanding of this recurring disorder. We aimed to investigate dynamic functional connectivity alternations in unmedicated individuals with current or past MDD using co-activation pattern analyses. METHODS Resting-state functional magnetic resonance imaging data were acquired from individuals with first-episode current MDD (cMDD, n = 50), remitted MDD (rMDD, n = 44), and healthy controls (HCs, n = 64). Using a data-driven consensus clustering technique, four whole-brain states of spatial co-activation were identified and associated metrics (dominance, entries, transition frequency) were analyzed with respect to clinical characteristics. RESULTS Relative to rMDD and HC, cMDD showed increased dominance and entries of state 1 (primarily involving default mode network (DMN)), and decreased dominance of state 4 (mostly involving frontal-parietal network (FPN)). Among cMDD, state 1 entries correlated positively with trait rumination. Conversely, relative to cMDD and HC, individuals with rMDD were characterized by increased state 4 entries. Relative to HC, both MDD groups showed increased state 4-to-1 (FPN to DMN) transition frequency but reduction in state 3 (spanning visual attention, somatosensory, limbic networks), with the former metric specifically related to trait rumination. LIMITATIONS Further confirmation with longitudinal studies are required. CONCLUSIONS Regardless of symptoms, MDD was characterized by increased FPN-to-DMN transitions and reduced dominance of a hybrid network. State-related effect emerged in regions critically implicated in repetitive introspection and cognitive control. Asymptomatic individuals with past MDD were uniquely linked to increased FPN entries. Our findings identify trait-like brain network dynamics that might increase vulnerability to future MDD.
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Affiliation(s)
- Chengwen Liu
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center for Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Emily L Belleau
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Daifeng Dong
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center for Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Xiaoqiang Sun
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center for Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Ge Xiong
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center for Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Diego A Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Xiang Wang
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center for Mental Disorders (Xiangya), Changsha, Hunan, PR China.
| | - Shuqiao Yao
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center for Mental Disorders (Xiangya), Changsha, Hunan, PR China.
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14
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Auerbach RP, Lan R, Galfalvy H, Alqueza KL, Cohn JF, Crowley RN, Durham K, Joyce KJ, Kahn LE, Kamath RA, Morency LP, Porta G, Srinivasan A, Zelazny J, Brent DA, Allen NB. Intensive Longitudinal Assessment of Adolescents to Predict Suicidal Thoughts and Behaviors. J Am Acad Child Adolesc Psychiatry 2023; 62:1010-1020. [PMID: 37182586 PMCID: PMC10524866 DOI: 10.1016/j.jaac.2023.03.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 03/24/2023] [Accepted: 05/05/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVE Suicide is a leading cause of death among adolescents. However, there are no clinical tools to detect proximal risk for suicide. METHOD Participants included 13- to 18-year-old adolescents (N = 103) reporting a current depressive, anxiety, and/or substance use disorder who owned a smartphone; 62% reported current suicidal ideation, with 25% indicating a past-year attempt. At baseline, participants were administered clinical interviews to assess lifetime disorders and suicidal thoughts and behaviors (STBs). Self-reports assessing symptoms and suicide risk factors also were obtained. In addition, the Effortless Assessment of Risk States (EARS) app was installed on adolescent smartphones to acquire daily mood and weekly suicidal ideation severity during the 6-month follow-up period. Adolescents completed STB and psychiatric service use interviews at the 1-, 3-, and 6-month follow-up assessments. RESULTS K-means clustering based on aggregates of weekly suicidal ideation scores resulted in a 3-group solution reflecting high-risk (n = 26), medium-risk (n = 47), and low-risk (n = 30) groups. Of the high-risk group, 58% reported suicidal events (ie, suicide attempts, psychiatric hospitalizations, emergency department visits, ideation severity requiring an intervention) during the 6-month follow-up period. For participants in the high-risk and medium-risk groups (n = 73), mood disturbances in the preceding 7 days predicted clinically significant ideation, with a 1-SD decrease in mood doubling participants' likelihood of reporting clinically significant ideation on a given week. CONCLUSION Intensive longitudinal assessment through use of personal smartphones offers a feasible method to assess variability in adolescents' emotional experiences and suicide risk. Translating these tools into clinical practice may help to reduce the needless loss of life among adolescents.
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Affiliation(s)
- Randy P Auerbach
- Columbia University, New York, and New York State Psychiatric Institute, New York; Sackler Institute, New York.
| | - Ranqing Lan
- Columbia University, New York, and New York State Psychiatric Institute, New York
| | - Hanga Galfalvy
- Columbia University, New York, and New York State Psychiatric Institute, New York
| | - Kira L Alqueza
- Columbia University, New York, and New York State Psychiatric Institute, New York
| | | | | | - Katherine Durham
- Columbia University, New York, and New York State Psychiatric Institute, New York
| | - Karla J Joyce
- University Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - Rahil A Kamath
- Columbia University, New York, and New York State Psychiatric Institute, New York
| | | | - Giovanna Porta
- University Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Apoorva Srinivasan
- Columbia University, New York, and New York State Psychiatric Institute, New York
| | - Jamie Zelazny
- University Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - David A Brent
- University Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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15
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Umemoto A, Zhou Z, Millon EM, Koshy CS, Taylor SM, Spann MN, Monk C, Marsh R, Rosellini AJ, Auerbach RP. Intergenerational transmission of cognitive control capacity among children at risk for depression. Biol Psychol 2023; 182:108652. [PMID: 37516422 PMCID: PMC10528753 DOI: 10.1016/j.biopsycho.2023.108652] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 07/31/2023]
Abstract
A maternal history of major depressive disorder (MDD) is a well-known risk factor for depression in offspring. However, the mechanism through which familial risk is transmitted remains unclear. Cognitive control alterations are common in MDD, and thus, the current study investigated whether altered control capacity is transmitted intergenerationally, and whether it then contributes to the developmental pathways through which depression is passed from mothers to children. We recruited children (N = 65) ages 4-10-years-old, of which 47.7 % (n = 31) reported a maternal history of MDD, and their biological mother (N = 65). Children performed a child-friendly Go/NoGo task while electroencephalography (EEG) data were recorded, and mothers performed a Flanker task. Children exhibited heightened sensitivity to error versus correct responses, which was characterized by an error-related negativity (ERN), error positivity (Pe) as well as prominent delta and frontal midline theta (FMT) oscillations. Interestingly, worse maternal performance on the Flanker task associated with an increased Go/NoGo error rate and a smaller ERN and Pe in children. However, there was no association between maternal or child control indices with child depression symptoms. Our results suggest a familial influence of cognitive control capacity in mother-child dyads, but it remains unclear whether this confers risk for depressive symptoms in children. Further research is necessary to determine whether alterations in cognitive control over time may influence symptom development in at-risk children.
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Affiliation(s)
- Akina Umemoto
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Zhixin Zhou
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA
| | - Emma M Millon
- Department of Psychiatry, Columbia University, New York, NY, USA; Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Christina S Koshy
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA
| | - Sydney M Taylor
- Department of Psychiatry, Columbia University, New York, NY, USA; Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Marisa N Spann
- Department of Psychiatry, Columbia University, New York, NY, USA; Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Catherine Monk
- Department of Psychiatry, Columbia University, New York, NY, USA; Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA; Division of Behavioral Medicine, New York State Psychiatric Institute, New York, NY, USA
| | - Rachel Marsh
- Department of Psychiatry, Columbia University, New York, NY, USA; Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | | | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA; Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA; Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA.
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16
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Jones LB, Vereschagin M, Wang AY, Munthali RJ, Pei J, Richardson CG, Halli P, Xie H, Rush B, Yatham L, Gadermann AM, Pendakur K, Prescivalli AP, Munro L, Bruffaerts R, Auerbach RP, Mortier P, Vigo DV. Suicidal Ideation Amongst University Students During the COVID-19 Pandemic: Time Trends and Risk Factors. Can J Psychiatry 2023; 68:531-546. [PMID: 36475311 PMCID: PMC9732498 DOI: 10.1177/07067437221140375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Examine time trends in suicidal ideation in post-secondary students over the first three waves of the COVID-19 pandemic in Canada and identify subpopulations of students with increased risk. METHOD We analysed 14 months of data collected through repeated cross-sectional deployment of the World Health Organization (WHO) World Mental Health-International College Student (WMH-ICS) survey at the University of British Columbia. Estimated log odds weekly trends of 30-day suicidal ideation (yes/no) were plotted against time with adjustments for demographics using binary logistic generalized additive model (GAM). Risk factors for 30-day suicidal ideation frequency (four categories) were examined using the ordered logistic GAM, with a cubic smoothing spline for modelling time trend in obervation weeks and accounting for demographics. RESULTS Nearly one-fifth (18.9%) of students experienced suicidal ideation in the previous 30 days. While the estimated log odds suggested that binary suicidal ideation was relatively stable across the course of the pandemic, an initial drop followed by an increasing trend was observed. Risk factors for suicidal ideation frequency during the pandemic included identifying as Chinese or as another non-Indigenous ethnic minority; experiencing current symptoms of depression or anxiety; having a history of suicidal planning or attempts; and feeling overwhelmed but unable to get help as a result of COVID-19. Older age was identified as a protective factor. CONCLUSIONS The general university student population in our study was relatively resilient with respect to suicidal ideation during the first three waves of the pandemic, but trends indicate the possibility of delayed impact. Specific sub-populations were found to be at increased risk and should be considered for targeted support. Further analyses should be undertaken to continue monitoring suicidality trends throughout the remainder of the pandemic and beyond.
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Affiliation(s)
- Laura B. Jones
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Melissa Vereschagin
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Angel Y. Wang
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Richard J. Munthali
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Julia Pei
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Chris G. Richardson
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Priyanka Halli
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Hui Xie
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Brian Rush
- Department of Psychiatry & School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Lakshmi Yatham
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Anne M. Gadermann
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Krishna Pendakur
- Department of Economics, Simon Fraser University, Burnaby, BC, Canada
| | - Ana Paula Prescivalli
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Lonna Munro
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Ronny Bruffaerts
- Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | | | - Philippe Mortier
- Health Services Research Unit, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Daniel V. Vigo
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Zhang J, Raya J, Morfini F, Urban Z, Pagliaccio D, Yendiki A, Auerbach RP, Bauer CCC, Whitfield-Gabrieli S. Reducing default mode network connectivity with mindfulness-based fMRI neurofeedback: a pilot study among adolescents with affective disorder history. Mol Psychiatry 2023; 28:2540-2548. [PMID: 36991135 PMCID: PMC10611577 DOI: 10.1038/s41380-023-02032-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 03/02/2023] [Accepted: 03/10/2023] [Indexed: 03/31/2023]
Abstract
Adolescents experience alarmingly high rates of major depressive disorder (MDD), however, gold-standard treatments are only effective for ~50% of youth. Accordingly, there is a critical need to develop novel interventions, particularly ones that target neural mechanisms believed to potentiate depressive symptoms. Directly addressing this gap, we developed mindfulness-based fMRI neurofeedback (mbNF) for adolescents that aims to reduce default mode network (DMN) hyperconnectivity, which has been implicated in the onset and maintenance of MDD. In this proof-of-concept study, adolescents (n = 9) with a lifetime history of depression and/or anxiety were administered clinical interviews and self-report questionnaires, and each participant's DMN and central executive network (CEN) were personalized using a resting state fMRI localizer. After the localizer scan, adolescents completed a brief mindfulness training followed by a mbNF session in the scanner wherein they were instructed to volitionally reduce DMN relative to CEN activation by practicing mindfulness meditation. Several promising findings emerged. First, mbNF successfully engaged the target brain state during neurofeedback; participants spent more time in the target state with DMN activation lower than CEN activation. Second, in each of the nine adolescents, mbNF led to significantly reduced within-DMN connectivity, which correlated with post-mbNF increases in state mindfulness. Last, a reduction of within-DMN connectivity mediated the association between better mbNF performance and increased state mindfulness. These findings demonstrate that personalized mbNF can effectively and non-invasively modulate the intrinsic networks associated with the emergence and persistence of depressive symptoms during adolescence.
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Affiliation(s)
- Jiahe Zhang
- Department of Psychology, Northeastern University, Boston, MA, 02115, USA.
| | - Jovicarole Raya
- Department of Psychology, Northeastern University, Boston, MA, 02115, USA
| | - Francesca Morfini
- Department of Psychology, Northeastern University, Boston, MA, 02115, USA
| | - Zoi Urban
- Department of Psychology, Northeastern University, Boston, MA, 02115, USA
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Anastasia Yendiki
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02129, USA
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- New York State Psychiatric Institute, New York, NY, 10032, USA
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, 10032, USA
| | - Clemens C C Bauer
- Department of Psychology, Northeastern University, Boston, MA, 02115, USA
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Susan Whitfield-Gabrieli
- Department of Psychology, Northeastern University, Boston, MA, 02115, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02129, USA
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
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18
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Husky MM, Sadikova E, Lee S, Alonso J, Auerbach RP, Bantjes J, Bruffaerts R, Cuijpers P, Ebert DD, Garcia RG, Hasking P, Mak A, McLafferty M, Sampson NA, Stein DJ, Kessler RC. Childhood adversities and mental disorders in first-year college students: results from the World Mental Health International College Student Initiative. Psychol Med 2023; 53:2963-2973. [PMID: 37449483 PMCID: PMC10349206 DOI: 10.1017/s0033291721004980] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND This study investigates associations of several dimensions of childhood adversities (CAs) with lifetime mental disorders, 12-month disorder persistence, and impairment among incoming college students. METHODS Data come from the World Mental Health International College Student Initiative (WMH-ICS). Web-based surveys conducted in nine countries (n = 20 427) assessed lifetime and 12-month mental disorders, 12-month role impairment, and seven types of CAs occurring before the age of 18: parental psychopathology, emotional, physical, and sexual abuse, neglect, bullying victimization, and dating violence. Poisson regressions estimated associations using three dimensions of CA exposure: type, number, and frequency. RESULTS Overall, 75.8% of students reported exposure to at least one CA. In multivariate regression models, lifetime onset and 12-month mood, anxiety, and substance use disorders were all associated with either the type, number, or frequency of CAs. In contrast, none of these associations was significant when predicting disorder persistence. Of the three CA dimensions examined, only frequency was associated with severe role impairment among students with 12-month disorders. Population-attributable risk simulations suggest that 18.7-57.5% of 12-month disorders and 16.3% of severe role impairment among those with disorders were associated with these CAs. CONCLUSION CAs are associated with an elevated risk of onset and impairment among 12-month cases of diverse mental disorders but are not involved in disorder persistence. Future research on the associations of CAs with psychopathology should include fine-grained assessments of CA exposure and attempt to trace out modifiable intervention targets linked to mechanisms of associations with lifetime psychopathology and burden of 12-month mental disorders.
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Affiliation(s)
- Mathilde M. Husky
- Laboratoire de Psychologie EA4139, Université de Bordeaux, Bordeaux, France
| | - Ekaterina Sadikova
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, US
| | - Sue Lee
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute; Pompeu Fabra University (UPF); and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, South Africa
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - David D. Ebert
- Department for Sport and Health Sciences, Chair for Psychology & Digital Mental Health Care, Technical University Munich, Germany
| | - Raùl Gutiérrez Garcia
- Department of Social Sciences and Humanities, De La Salle Bajio University, Salamanca, Guanajuato, Mexico
| | - Penelope Hasking
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Arthur Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR
| | | | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Dan J. Stein
- Department of Psychiatry & Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, Republic of South Africa
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
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Abstract
BACKGROUND Given low base rates of suicidal thoughts and behaviors (STBs) in national samples of adolescents, clarifying the sociodemographic and clinical correlates among psychiatric inpatients may afford insights into potential risk factors that predict STBs onset. METHOD Adolescents (N = 970; ages 12-19 years) admitted for acute, psychiatric inpatient care completed baseline clinical interviews and self-report measures assessing demographics and early life adversity. Lifetime and 12-month STBs prevalence were obtained, allowing for the estimate of STBs persistence (i.e., rates of those with both current and past STBs) and transition rates (i.e., proportion of ideators that transition to plans or attempts). Univariate and multivariate logistic regression tested sociodemographic and clinical correlates of STBs. RESULTS Age-of-onset for STBs occurred in early adolescence. Most patients reported suicide ideation with nearly half of patients making a plan and one-third a suicide attempt. Although relatively modest, the strongest correlates of lifetime attempts were depressive disorders, physical abuse, and non-suicidal self-injury. Knowing a peer that had attempted suicide also increased the likelihood of a suicide attempt, especially among attempters who transitioned from ideation to planned attempts. CONCLUSION STBs are highly prevalent among adolescents admitted for acute psychiatric inpatient treatment. The modest effects suggest that correlates, particularly those related to suicide attempts, are widely distributed. As a history of physical abuse and knowing a peer with a suicide attempt history are related to transitioning from ideation to action, these may be critical factors to target in the deployment of future suicide prevention and treatment programs. HIGHLIGHTSOne-third of adolescent inpatients report a lifetime history of suicide attempts.Approximately 65% of adolescent inpatients with a lifetime plan attempt suicide.Knowing peers who attempt suicide may facilitate the transition from ideation to action.
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Affiliation(s)
- Kira L. Alqueza
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Katherine Durham
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Apoorva Srinivasan
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Jeremy G. Stewart
- Department of Psychology and Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
| | - Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA
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20
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Mann JJ, Michel CA, Auerbach RP. Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. Focus (Am Psychiatr Publ) 2023; 21:182-196. [PMID: 37201140 PMCID: PMC10172556 DOI: 10.1176/appi.focus.23021004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Objective The authors sought to identify scalable evidence-based suicide prevention strategies. Methods A search of PubMed and Google Scholar identi- fied 20,234 articles published between September 2005 and December 2019, of which 97 were randomized controlled trials with suicidal behavior or ideation as primary outcomes or epidemiological studies of limiting access to lethal means, using educational approaches, and the impact of antidepressant treatment. Results Training primary care physicians in depression rec- ognition and treatment prevents suicide. Educating youths on depression and suicidal behavior, as well as active out- reach to psychiatric patients after discharge or a suicidal crisis, prevents suicidal behavior. Meta-analyses find that antidepressants prevent suicide attempts, but individual randomized controlled trials appear to be underpowered. Ketamine reduces suicidal ideation in hours but is untested for suicidal behavior prevention. Cognitive-behavioral therapy and dialectical behavior therapy prevent suicidal behavior. Active screening for suicidal ideation or behavior is not proven to be better than just screening for depression. Education of gatekeepers about youth suicidal behavior lacks effectiveness. No randomized trials have been reported for gatekeeper training for prevention of adult suicidal behavior. Algorithm-driven electronic health record screening, Internet-based screening, and smartphone passive monitoring to identify high-risk patients are under-studied. Means restriction, including of firearms, prevents suicide but is sporadically employed in the United States, even though firearms are used in half of all U.S. suicides. Conclusions Training general practitioners warrants wider implementation and testing in other nonpsychiatrist physi- cian settings. Active follow-up of patients after discharge or a suicide-related crisis should be routine, and restricting firearm access by at-risk individuals warrants wider use. Combination approaches in health care systems show promise in reducing suicide in several countries, but evaluating the benefit attributable to each component is essential. Further suicide rate reduction requires evaluating newer approaches, such as electronic health record-derived algorithms, Internet-based screening methods, ketamine's potential benefit for preventing attempts, and passive monitoring of acute suicide risk change.Reprinted from Am J Psychiatry 2021; 178:611-624, with permission from American Psychiatric Association Publishing. Copyright © 2021.
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Affiliation(s)
- J John Mann
- Division of Molecular Imaging and Neuropathology (Mann, Michel) and Division of Child and Adolescent Psychiatry (Auerbach), New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York (Mann, Auerbach); Division of Clinical Developmental Neuro- science, Sackler Institute for Developmental Psychobiology, Columbia University, New York (Auerbach)
| | - Christina A Michel
- Division of Molecular Imaging and Neuropathology (Mann, Michel) and Division of Child and Adolescent Psychiatry (Auerbach), New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York (Mann, Auerbach); Division of Clinical Developmental Neuro- science, Sackler Institute for Developmental Psychobiology, Columbia University, New York (Auerbach)
| | - Randy P Auerbach
- Division of Molecular Imaging and Neuropathology (Mann, Michel) and Division of Child and Adolescent Psychiatry (Auerbach), New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York (Mann, Auerbach); Division of Clinical Developmental Neuro- science, Sackler Institute for Developmental Psychobiology, Columbia University, New York (Auerbach)
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21
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Li LY, Glazer JE, Helgren F, Funkhouser CJ, Auerbach RP, Shankman SA. Electrophysiological evidence of mal-adaptation to error in remitted depression. Biol Psychol 2023; 179:108555. [PMID: 37031811 PMCID: PMC10175186 DOI: 10.1016/j.biopsycho.2023.108555] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/06/2023] [Accepted: 04/06/2023] [Indexed: 04/11/2023]
Abstract
Identifying risk markers for major depressive disorder (MDD) that persist into remission is key to address MDD's high rate of recurrence. Central to MDD recurrence are the disorder's negative information processing biases, such as heightened responses to errors, which may subsequently impair abilities to monitor performance and adjust behaviors based on environmental demands. However, little is known regarding the neurophysiological correlates of post-error adaptation in depression. The current study investigated event-related potentials (ERPs) and behavioral performance following errors from a flanker task in 58 participants with remitted MDD (rMDD) and 118 healthy controls (HC). Specifically, using trial-level data, we tested: (a) the impact of errors on response-locked ERPs of the current and post-error trials (error-related negativity [ERN] and correct response negativity [CRN]) and (b) longer-term adaptation to errors (ERN/CRN) over the course of the task. Compared to HC, rMDD participants showed a larger ERN to the current trial and smaller habituation in ERN over time. On trials immediately following errors, rMDD participants showed slower reaction times that were predicted by the previous-trial ERN amplitude but comparable accuracy to HC, suggesting a deficient ability to disengage from errors and/or a compensatory effort to mitigate accuracy decrements. Critically, this pattern of responding: (a) was concurrently associated with greater levels of anhedonia symptoms, more severe MDD history, and interpersonal impairment (but lower impairment in life activities) and (b) predicted more anhedonia symptoms at one-year follow-up. Collectively, a hyperactive performance monitoring system may be a useful risk marker for future MDD recurrence.
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Affiliation(s)
- Lilian Y Li
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA.
| | - James E Glazer
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Fiona Helgren
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Carter J Funkhouser
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA; Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA; Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA
| | - Stewart A Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
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22
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Bootsma E, Jansen L, Kiekens G, Voorpoels W, Mortier P, Proost S, Vande Poel I, Jacobs K, Demyttenaere K, Alonso J, Kessler RC, Cuijpers P, Auerbach RP, Bruffaerts R. Mood disorders in higher education in Flanders during the 2 nd and 3 rd COVID-19 wave: Prevalence and help-seeking: Findings from the Flemish College Surveys (FLeCS). J Psychiatr Res 2023; 159:33-41. [PMID: 36657312 DOI: 10.1016/j.jpsychires.2023.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 11/21/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
To examine the prevalence of 12-month mood disorders and receipt of mental health treatment among a volunteer sample of higher education students during the 2nd and 3rd COVID-19 wave in the Flanders region. Web-based self-report surveys were obtained from 9101 students in higher education in the Flemish College Surveys (FLeCS) in Flanders, Belgium. As part of the World Health Organization's World Mental Health-International College Student Initiative, we screened for 12-month mood disorders (major depressive episode (MDE), mania/hypomania), and service use. We used poststratification weights to generate population-representative data on key socio-demographic characteristics. 50.6% of the respondents screened positive for 12-month mood disorders (46.8% MDE, of which 22.9% with very severe impact). Use of services was very low, with estimates of 35.4% for MDE, 31.7% for mania, and 25.5% for hypomania. Even among students with very severe disorders, treatment rates were never higher than 48.3%. Most common barriers for not using services were: the preference to handle the problem alone (83.4%) and not knowing where to seek professional help (79.8%). We found a high unmet need for mood problems among college students; though caution is needed in interpreting these findings given the volunteer nature of the sample. A reallocation of treatment resources for higher education students should be considered, particulary services that focus on innovative, low-threshold, and scalable interventions.
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Affiliation(s)
- Erik Bootsma
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Belgium; The KU Leuven - VIB Center for Microbiology, Leuven, Belgium.
| | - Leontien Jansen
- Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium
| | - Glenn Kiekens
- Faculty of Psychology and Educational Sciences, Clinical Psychology, KU Leuven, Leuven, Belgium; Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | | | - Philippe Mortier
- Health Services Research Unit, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Sebastian Proost
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Belgium; The KU Leuven - VIB Center for Microbiology, Leuven, Belgium
| | - Ilse Vande Poel
- Knowledge and Innovation Center FOOD, University Colleges Leuven-Limburg, Leuven, Belgium
| | - Karen Jacobs
- Knowledge and Innovation Center FOOD, University Colleges Leuven-Limburg, Leuven, Belgium
| | - Koen Demyttenaere
- Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium; Campus Gasthuisberg, Universitair Psychiatrisch Centrum KU Leuven (UPC-KUL), Leuven, Belgium
| | - Jordi Alonso
- Health Services Research Unit, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, MA, USA
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, USA; Division of Clinical Developmental Neuroscience, Sackler Institute, New York, USA
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium; Campus Gasthuisberg, Universitair Psychiatrisch Centrum KU Leuven (UPC-KUL), Leuven, Belgium
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23
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Stevens ES, Funkhouser CJ, Auerbach RP, Talati A, Gameroff MG, Posner JE, Weissman MM, Shankman SA. Inhibition Predicts the Course of Depression and Anxiety Symptoms Among Adolescents: The Moderating Role of Familial Risk. J Nerv Ment Dis 2023; 211:100-107. [PMID: 36044650 PMCID: PMC9892173 DOI: 10.1097/nmd.0000000000001584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
ABSTRACT Numerous theoretical models suggest that inhibition difficulties-the inability to moderate automatic responses-contribute to the onset and/or maintenance of internalizing symptoms. Inhibition deficits and internalizing disorders run in families and share overlapping genetic risk factors, suggesting that inhibition deficits may be particularly prognostic of internalizing symptoms in those with high familial risk. This study tested this hypothesis in a longitudinal sample during the transition from adolescence to early adulthood. As hypothesized, prospective associations between inhibition and anxiety and depressive symptoms 8 years later were moderated by familial risk for depression. Specifically, poorer inhibition prospectively predicted greater anxiety and depressive symptoms in those at high (but not low) familial risk for major depressive disorder. These findings provide preliminary support for impaired inhibition as an indicator of risk for later internalizing symptoms in those at high familial risk.
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Affiliation(s)
- Elizabeth S. Stevens
- University of Illinois at Chicago, Department of Psychology, 1007 W. Harrison Street, Chicago, IL 60607
| | - Carter J. Funkhouser
- University of Illinois at Chicago, Department of Psychology, 1007 W. Harrison Street, Chicago, IL 60607
| | - Randy P. Auerbach
- Columbia University, Vagelos College of Physicians and Surgeon, Department of Psychiatry, 1051 Riverside Drive, New York, NY 10032
- New York State Psychiatric Institute, Division of Translational Epidemiology, 1051 Riverside Drive, New York, NY 10032
| | - Ardesheer Talati
- Columbia University, Vagelos College of Physicians and Surgeon, Department of Psychiatry, 1051 Riverside Drive, New York, NY 10032
- New York State Psychiatric Institute, Division of Translational Epidemiology, 1051 Riverside Drive, New York, NY 10032
| | - Marc G. Gameroff
- Columbia University, Vagelos College of Physicians and Surgeon, Department of Psychiatry, 1051 Riverside Drive, New York, NY 10032
- New York State Psychiatric Institute, Division of Translational Epidemiology, 1051 Riverside Drive, New York, NY 10032
| | - Jonathan E. Posner
- Columbia University, Vagelos College of Physicians and Surgeon, Department of Psychiatry, 1051 Riverside Drive, New York, NY 10032
- New York State Psychiatric Institute, Division of Translational Epidemiology, 1051 Riverside Drive, New York, NY 10032
| | - Myrna M. Weissman
- Columbia University, Vagelos College of Physicians and Surgeon, Department of Psychiatry, 1051 Riverside Drive, New York, NY 10032
- New York State Psychiatric Institute, Division of Translational Epidemiology, 1051 Riverside Drive, New York, NY 10032
| | - Stewart A. Shankman
- Northwestern University, Department of Psychiatry and Behavioral Sciences, 680 N. Lake Shore Drive, Chicago, IL 60611
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Kiekens G, Hasking P, Bruffaerts R, Alonso J, Auerbach RP, Bantjes J, Benjet C, Boyes M, Chiu WT, Claes L, Cuijpers P, Ebert DD, Mak A, Mortier P, O’Neill S, Sampson NA, Stein DJ, Vilagut G, Nock MK, Kessler RC. Non-suicidal self-injury among first-year college students and its association with mental disorders: results from the World Mental Health International College Student (WMH-ICS) initiative. Psychol Med 2023; 53:875-886. [PMID: 34140062 PMCID: PMC8683565 DOI: 10.1017/s0033291721002245] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Although non-suicidal self-injury (NSSI) is an issue of major concern to colleges worldwide, we lack detailed information about the epidemiology of NSSI among college students. The objectives of this study were to present the first cross-national data on the prevalence of NSSI and NSSI disorder among first-year college students and its association with mental disorders. METHODS Data come from a survey of the entering class in 24 colleges across nine countries participating in the World Mental Health International College Student (WMH-ICS) initiative assessed in web-based self-report surveys (20 842 first-year students). Using retrospective age-of-onset reports, we investigated time-ordered associations between NSSI and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV) mood (major depressive and bipolar disorder), anxiety (generalized anxiety and panic disorder), and substance use disorders (alcohol and drug use disorder). RESULTS NSSI lifetime and 12-month prevalence were 17.7% and 8.4%. A positive screen of 12-month DSM-5 NSSI disorder was 2.3%. Of those with lifetime NSSI, 59.6% met the criteria for at least one mental disorder. Temporally primary lifetime mental disorders predicted subsequent onset of NSSI [median odds ratio (OR) 2.4], but these primary lifetime disorders did not consistently predict 12-month NSSI among respondents with lifetime NSSI. Conversely, even after controlling for pre-existing mental disorders, NSSI consistently predicted later onset of mental disorders (median OR 1.8) as well as 12-month persistence of mental disorders among students with a generalized anxiety disorder (OR 1.6) and bipolar disorder (OR 4.6). CONCLUSIONS NSSI is common among first-year college students and is a behavioral marker of various common mental disorders.
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Affiliation(s)
- Glenn Kiekens
- Center for Public Health Psychiatry, KU Leuven, Belgium
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Penelope Hasking
- School of Population Health, Curtin University, Perth, Australia
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, KU Leuven, Belgium
- Institute for Social Research, Population Studies Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Jordi Alonso
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública, Madrid, Spain
- Pompeu Fabra University, Barcelona, Spain
| | | | - Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences Stellenbosch University, South Africa
| | - Corina Benjet
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Mark Boyes
- School of Population Health, Curtin University, Perth, Australia
| | - Wai Tat Chiu
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - David D. Ebert
- Department for Sport and Health Sciences, Chair for Psychology & Digital Mental Health Care, Technical University Munich, Germany
| | - Arthur Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Philippe Mortier
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Siobhan O’Neill
- School of Biomedical Sciences, Ulster University, Derry-Londonderry, Northern Ireland
| | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Dan J. Stein
- Department of Psychiatry and Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Gemma Vilagut
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Matthew K. Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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Pagliaccio D, Kumar P, Kamath RA, Pizzagalli DA, Auerbach RP. Neural sensitivity to peer feedback and depression symptoms in adolescents: a 2-year multiwave longitudinal study. J Child Psychol Psychiatry 2023; 64:254-264. [PMID: 36082818 PMCID: PMC9840696 DOI: 10.1111/jcpp.13690] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Depression risk increases during adolescent development, and individual differences in neural sensitivity to peer feedback (rejection vs. acceptance) may be a key diathesis in understanding stress-related depression risk. METHODS At baseline, adolescents (12-14 years old; N = 124) completed clinical interviews and self-report symptom measures, and the Chatroom Task while MRI data were acquired. The majority of participants provided usable MRI data (N = 90; 76% female), which included adolescents with no maternal depression history (low risk n = 64) and those with a maternal depression history (high risk n = 26). Whole-brain regression models probed group differences in neural sensitivity following peer feedback, and whole-brain linear mixed-effects models examined neural sensitivity to peer feedback by peer stress interactions relating to depression symptoms at up to nine longitudinal assessments over 2 years. RESULTS Whole-brain cluster-corrected results indicated brain activation moderating the strong positive association between peer interpersonal stress and depression over time. This included activation in the anterior insula, cingulate, amygdala, and striatum during anticipation and receipt of feedback (i.e., rejection vs. acceptance). Moderation effects were stronger when examining peer interpersonal (vs. non-interpersonal) stress and in relation to depression (vs. social anxiety) symptoms. CONCLUSIONS Neural responses to peer feedback in key social and incentive processing brain regions may reflect core dispositional risk factors that interact with peer interpersonal stressors to predict adolescent depression symptom severity over time.
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Affiliation(s)
- David Pagliaccio
- New York State Psychiatric Institute, New York, NY, USA,Department of Psychiatry, Columbia University, New York, NY, USA
| | - Poornima Kumar
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Rahil A. Kamath
- New York State Psychiatric Institute, New York, NY, USA,Department of Psychiatry, Columbia University, New York, NY, USA
| | - Diego A. Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Randy P. Auerbach
- New York State Psychiatric Institute, New York, NY, USA,Department of Psychiatry, Columbia University, New York, NY, USA,Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA
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26
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Chow SM, Nahum-Shani I, Baker JT, Spruijt-Metz D, Allen NB, Auerbach RP, Dunton GF, Friedman NP, Intille SS, Klasnja P, Marlin B, Nock MK, Rauch SL, Pavel M, Vrieze S, Wetter DW, Kleiman EM, Brick TR, Perry H, Wolff-Hughes DL. The ILHBN: challenges, opportunities, and solutions from harmonizing data under heterogeneous study designs, target populations, and measurement protocols. Transl Behav Med 2023; 13:7-16. [PMID: 36416389 PMCID: PMC9853092 DOI: 10.1093/tbm/ibac069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The ILHBN is funded by the National Institutes of Health to collaboratively study the interactive dynamics of behavior, health, and the environment using Intensive Longitudinal Data (ILD) to (a) understand and intervene on behavior and health and (b) develop new analytic methods to innovate behavioral theories and interventions. The heterogenous study designs, populations, and measurement protocols adopted by the seven studies within the ILHBN created practical challenges, but also unprecedented opportunities to capitalize on data harmonization to provide comparable views of data from different studies, enhance the quality and utility of expensive and hard-won ILD, and amplify scientific yield. The purpose of this article is to provide a brief report of the challenges, opportunities, and solutions from some of the ILHBN's cross-study data harmonization efforts. We review the process through which harmonization challenges and opportunities motivated the development of tools and collection of metadata within the ILHBN. A variety of strategies have been adopted within the ILHBN to facilitate harmonization of ecological momentary assessment, location, accelerometer, and participant engagement data while preserving theory-driven heterogeneity and data privacy considerations. Several tools have been developed by the ILHBN to resolve challenges in integrating ILD across multiple data streams and time scales both within and across studies. Harmonization of distinct longitudinal measures, measurement tools, and sampling rates across studies is challenging, but also opens up new opportunities to address cross-cutting scientific themes of interest.
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Affiliation(s)
- Sy-Miin Chow
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802, USA
| | - Inbal Nahum-Shani
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Justin T Baker
- Department of Psychiatry, McLean Hospital, Boson, MA, USA
- Department of Psychiatry, Harvard Medical School, Boson, MA, USA
| | - Donna Spruijt-Metz
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | | | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Genevieve F Dunton
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Naomi P Friedman
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Stephen S Intille
- Khoury College of Computer Sciences, Northeastern University, Boston, MA, USA
- Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | - Predrag Klasnja
- School of Information, University of Michigan, Ann Arbor, MI, USA
| | - Benjamin Marlin
- College of Information and Computer Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Franciscan Children’s, Boston, MA, USA
- Children’s Hospital, Boston, MA, USA
| | - Scott L Rauch
- Department of Psychiatry, McLean Hospital, Boson, MA, USA
- Department of Psychiatry, Harvard Medical School, Boson, MA, USA
| | - Misha Pavel
- Khoury College of Computer Sciences, Northeastern University, Boston, MA, USA
- Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | - Scott Vrieze
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - David W Wetter
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Evan M Kleiman
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Timothy R Brick
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802, USA
- Institute for Computational and Data Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Heather Perry
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802, USA
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Mortier P, Alonso J, Auerbach RP, Bantjes J, Benjet C, Bruffaerts R, Cuijpers P, Ebert DD, Green JG, Hasking P, Karyotaki E, Kiekens G, Mak A, Nock MK, O'Neill S, Pinder-Amaker S, Sampson NA, Stein DJ, Vilagut G, Wilks C, Zaslavsky AM, Mair P, Kessler RC. Childhood adversities and suicidal thoughts and behaviors among first-year college students: results from the WMH-ICS initiative. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1591-1601. [PMID: 34424350 PMCID: PMC8878415 DOI: 10.1007/s00127-021-02151-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 07/30/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the associations of childhood adversities (CAs) with lifetime onset and transitions across suicidal thoughts and behaviors (STB) among incoming college students. METHODS Web-based self-report surveys administered to 20,842 incoming college students from nine countries (response rate 45.6%) assessed lifetime suicidal ideation, plans and attempts along with seven CAs: parental psychopathology, three types of abuse (emotional, physical, sexual), neglect, bully victimization, and dating violence. Logistic regression estimated individual- and population-level associations using CA operationalizations for type, number, severity, and frequency. RESULTS Associations of CAs with lifetime ideation and the transition from ideation to plan were best explained by the exact number of CA types (OR range 1.32-52.30 for exactly two to seven CAs). Associations of CAs with a transition to attempts were best explained by the frequency of specific CA types (scaled 0-4). Attempts among ideators with a plan were significantly associated with all seven CAs (OR range 1.16-1.59) and associations remained significant in adjusted analyses with the frequency of sexual abuse (OR = 1.42), dating violence (OR = 1.29), physical abuse (OR = 1.17) and bully victimization (OR = 1.17). Attempts among ideators without plan were significantly associated with frequency of emotional abuse (OR = 1.29) and bully victimization (OR = 1.36), in both unadjusted and adjusted analyses. Population attributable risk simulations found 63% of ideation and 30-47% of STB transitions associated with CAs. CONCLUSION Early-life adversities represent a potentially important driver in explaining lifetime STB among incoming college students. Comprehensive intervention strategies that prevent or reduce the negative effects of CAs may reduce subsequent onset of STB.
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Affiliation(s)
- Philippe Mortier
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Dr. Aiguader, 88, 08003, Barcelona, Spain.
- CIBER en Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain.
- Department of Neurosciences, Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium.
| | - Jordi Alonso
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Dr. Aiguader, 88, 08003, Barcelona, Spain
- CIBER en Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- Pompeu Fabra University (UPF), Barcelona, Spain
| | | | - Jason Bantjes
- Department of Global Health, Faculty of Medicine and Health Sciences, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Corina Benjet
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de La Fuente Muñiz, Mexico City, Mexico
| | - Ronny Bruffaerts
- Department of Neurosciences, Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium
- Institute for Social Research, Population Studies Center, University of Michigan, Ann Arbor, MI, USA
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - David D Ebert
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jennifer Greif Green
- Wheelock College of Education and Human Development, Boston University, Boston, USA
| | - Penelope Hasking
- School of Population Health, Curtin University, Perth, Australia
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Glenn Kiekens
- Department of Neurosciences, Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium
- Faculty of Psychology and Educational Sciences, Clinical Psychology, KU Leuven, Leuven, Belgium
- Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Arthur Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, People's Republic of China
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Siobhan O'Neill
- School of Psychology, Ulster University, Derry-Londonderry, Northern Ireland
| | - Stephanie Pinder-Amaker
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Dan J Stein
- Department of Psychiatry and Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, Republic of South Africa
| | - Gemma Vilagut
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Dr. Aiguader, 88, 08003, Barcelona, Spain
- CIBER en Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
| | - Chelsey Wilks
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Alan M Zaslavsky
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Patrick Mair
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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28
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Ballester L, Alayo I, Vilagut G, Mortier P, Almenara J, Cebrià AI, Echeburúa E, Gabilondo A, Gili M, Lagares C, Piqueras JA, Roca M, Soto-Sanz V, Blasco MJ, Castellví P, Miranda-Mendizabal A, Bruffaerts R, Auerbach RP, Nock MK, Kessler RC, Alonso J. Predictive models for first-onset and persistence of depression and anxiety among university students. J Affect Disord 2022; 308:432-441. [PMID: 35398107 DOI: 10.1016/j.jad.2021.10.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Depression and anxiety are both prevalent among university students. They frequently co-occur and share risk factors. Yet few studies have focused on identifying students at highest risk of first-onset and persistence of either of these conditions. METHODS Multicenter cohort study among Spanish first-year university students. At baseline, students were assessed for lifetime and 12-month Major Depressive Episode and/or Generalized Anxiety Disorder (MDE-GAD), other mental disorders, childhood-adolescent adversities, stressful life events, social support, socio-demographics, and psychological factors using web-based surveys; 12-month MDE-GAD was again assessed at 12-month follow-up. RESULTS A total of 1253 students participated in both surveys (59.2% of baseline respondents; mean age = 18.7 (SD = 1.3); 56.0% female). First-onset of MDE-GAD at follow-up was 13.3%. Also 46.7% of those with baseline MDE-GAD showed persistence at follow-up. Childhood/Adolescence emotional abuse or neglect (OR= 4.33), prior bipolar spectrum disorder (OR= 4.34), prior suicidal ideation (OR=4.85) and prior lifetime symptoms of MDE (ORs=2.33-3.63) and GAD (ORs=2.15-3.75) were strongest predictors of first-onset MDE-GAD. Prior suicidal ideation (OR=3.17) and prior lifetime GAD symptoms (ORs=2.38-4.02) were strongest predictors of MDE-GAD persistence. Multivariable predictions from baseline showed AUCs of 0.76 for first-onset and 0.81 for persistence. 74.9% of first-onset MDE-GAD cases occurred among 30% students with highest predicted risk at baseline. LIMITATIONS Self-report data were used; external validation of the multivariable prediction models is needed. CONCLUSION MDE-GAD among university students is frequent, suggesting the need to implement web-based screening at university entrance that identify those students with highest risk.
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Affiliation(s)
- Laura Ballester
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; Girona University (UdG), Girona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Itxaso Alayo
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Philippe Mortier
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Ana Isabel Cebrià
- Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell, Spain; CIBER Salud Mental (CIBERSAM), Madrid, Spain
| | | | - Andrea Gabilondo
- BioDonostia Health Research Institute, Osakidetza, San Sebastián, Spain
| | - Margalida Gili
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISBA), Rediapp, University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | | | | | - Miquel Roca
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISBA), Rediapp, University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | | | - Maria Jesús Blasco
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Pere Castellví
- International University of Catalonia (UIC), Barcelona, Spain
| | | | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum (UPC-KUL), Center for Public Health Psychiatry, KULeuven, Leuven, Belgium
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, United States
| | - Matthew K Nock
- Department of Psychology, Harvard University, Boston, MA, United States
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
| | - Jordi Alonso
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Medicine and Life Scienes, Universitat Pompeu Fabra, Barcelona, Spain.
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29
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Benjet C, Mortier P, Kiekens G, Ebert DD, Auerbach RP, Kessler RC, Cuijpers P, Green JG, Nock MK, Demyttenaere K, Albor Y, Bruffaerts R. A risk algorithm that predicts alcohol use disorders among college students. Eur Child Adolesc Psychiatry 2022; 31:1-11. [PMID: 33723648 PMCID: PMC9336831 DOI: 10.1007/s00787-020-01712-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 12/21/2020] [Indexed: 12/13/2022]
Abstract
The first year of college may carry especially high risk for onset of alcohol use disorders. We assessed the one-year incidence of alcohol use disorders (AUD) among incoming first-year students, predictors of AUD-incidence, prediction accuracy and population impact. A prospective cohort study of first-year college students (baseline: N = 5843; response rate = 51.8%; 1-year follow-up: n = 1959; conditional response rate = 41.6%) at a large university in Belgium was conducted. AUD were evaluated with the AUDIT and baseline predictors with the Composite International Diagnostic Interview Screening Scales (CIDI-SC). The one-year incidence of AUD was 3.9% (SE = 0.4). The most important individual-level baseline predictors of AUD incidence were being male (OR = 1.53; 95% CI = 1.12-2.10), a break-up with a romantic partner (OR = 1.67; 95% CI = 1.08-2.59), hazardous drinking (OR = 3.36; 95% CI = 1.31-8.63), and alcohol use characteristics at baseline (ORs between 1.29 and 1.38). Multivariate cross-validated prediction (cross-validated AUC = 0.887) shows that 55.5% of incident AUD cases occurred among the 10% of students at highest predicted risk (20.1% predicted incidence in this highest-risk subgroup). Four out of five students with incident AUD would hypothetically be preventable if baseline hazardous drinking was to be eliminated along with a reduction of one standard deviation in alcohol use characteristics scores, and another 15.0% would potentially be preventable if all 12-month stressful events were eliminated. Screening at college entrance is a promising strategy to identify students at risk of transitioning to more problematic drinking and AUD, thus improving the development and deployment of targeted preventive interventions.
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Affiliation(s)
- C Benjet
- Department of Epidemiology and Psychosocial Research, National Institute of Psychiatry Instituto Nacional de Psiquiatría Ramón de La Fuente Muñiz, Calzada México-Xochimilco 101, San Lornenzo Huipulco, CDMX, 14370, Mexico City, Mexico.
| | - P Mortier
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium
| | - G Kiekens
- Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium
- School of Psychology, Curtin University, Perth, Australia
| | - D D Ebert
- Clinical Psychology and Psychotherapy, Department of Psychology, Friedrich-Alexander-UniversityErlangen-Nürnberg, Erlangen, Germany
| | - R P Auerbach
- Department of Psychiatry, Columbia University, New York, USA
| | - R C Kessler
- Department of Health Care Policy, Harvard Medical School, Harvard University, Boston, MA, USA
| | - P Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - J G Green
- Wheelock College of Education and Human Development, Boston University, Boston, MA, USA
| | - M K Nock
- Department of Psychology, Harvard University, Cambridge, MA, 0000-0001-6508-1145, USA
| | - K Demyttenaere
- Universitair Psychiatrisch Centrum, Public Health Psychiatry, KU Leuven, Leuven, Belgium
| | - Y Albor
- National Institute of Psychiatry Ramón de La Fuente Muñiz, Mexico City and Universidad Cuauhtémoc Plantel Aguascalientes, Aguascalientes, Mexico
| | - R Bruffaerts
- Universitair Psychiatrisch Centrum, Public Health Psychiatry, KU Leuven, Leuven, Belgium
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Mak AD, Lee S, Sampson NA, Albor Y, Alonso J, Auerbach RP, Baumeister H, Benjet C, Bruffaerts R, Cuijpers P, Ebert DD, Gutierrez-Garcia RA, Hasking P, Lapsley C, Lochner C, Kessler RC. ADHD Comorbidity Structure and Impairment: Results of the WHO World Mental Health Surveys International College Student Project (WMH-ICS). J Atten Disord 2022; 26:1078-1096. [PMID: 34753324 PMCID: PMC9064996 DOI: 10.1177/10870547211057275] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To examine the prevalence of ADHD and the association of comorbid disorders, and multivariate disorder classes with role impairment in college students. METHOD About 15,991 freshmen (24 colleges, 9 countries, WMH-ICS) (response rate = 45.6%) completed online WMH-CIDI-SC surveys for 6-month ADHD and six 12-month DSM-IV disorders. We examined multivariate disorder classes using latent class analysis (LCA) and simulated a population attributable risk proportions (PARPs) of ADHD-related impairment. RESULTS About 15.9% had ADHD, of which 58.4% had comorbidities. LCA classified ADHD respondents to pure (42.9%), internalizing (36.0%), bipolar comorbidities (11.3%), and externalizing disorder classes (9.8%). ADHD, comorbidities, and multivariate disorder classes independently predicted severe impairment. PARPs: eliminating ADHD hypothetically reduced severe impairment by 19.2%, 10.1% adjusted for comorbidities, 9.5% for multivariate disorder classes. CONCLUSIONS ADHD and comorbid disorders are common and impairing in college students. Personalized transdiagnostic interventions guided by multivariate disorder classes should be explored.
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Affiliation(s)
- Arthur D.P. Mak
- Department of Psychiatry, The Chinese University of Hong Kong, G/F Multicentre, Tai Po Hospital, Tai Po, Hong Kong SAR
| | - Sue Lee
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Yesica Albor
- Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz, Mexico City, Mexico
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain,CIBER en Epidemiología y Salud Pública (CIBERESP), Spain,Pompeu Fabra University (UPF), Barcelona, Spain
| | | | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Corina Benjet
- Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz, Mexico City, Mexico
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - David D. Ebert
- Department for Sport and Health Sciences, Technical University Munich; Munich, Germany
| | - Raúl A. Gutierrez-Garcia
- Department of Social Sciences and Humanities, De La Salle Bajio University, Salamanca, Guanajuato, Mexico
| | - Penelope Hasking
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Coral Lapsley
- Northern Ireland Centre for Stratified Medicine, Biomedical Sciences Research Institute, Ulster University, Derry, United Kingdom
| | - Christine Lochner
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, South Africa
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
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Auerbach RP, Srinivasan A, Kirshenbaum JS, Mann JJ, Shankman SA. Geolocation features differentiate healthy from remitted depressed adults. J Psychopathol Clin Sci 2022; 131:341-349. [PMID: 35230855 PMCID: PMC9296907 DOI: 10.1037/abn0000742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Depression recurrence is debilitating, and there is a pressing need to develop clinical tools that detect the reemergence of symptoms with the aim of bridging patients to treatment before recurrences. At baseline, remitted depressed adults (n = 22) and healthy controls (n = 24) were administered clinical interviews and completed self-report symptom measures. Then, smartphone apps were installed on personal smartphones to acquire geolocation data over 21 days and ecological momentary assessment of positive and negative affect during the initial 14-day period. Compared with healthy controls, remitted depressed adults exhibited reduced circadian routine (regularity of one's daily routine) and lower average daily distance traveled. Further, reduced distance traveled associated with greater daily negative affect after controlling for depression severity; however, this effect was not more pronounced among remitted adults. A least absolute shrinkage and selection operator (LASSO) regression indicated that a linear combination of circadian routine, average distance traveled, and baseline depression severity classified remitted depressed individuals with 72% accuracy; outperforming models restricted to either geolocation or clinical measures alone. Mobile sensing approaches hold enormous promise to improve clinical care for depressive disorders. Although barriers remain, leveraging technological advancements related to real-time monitoring can improve treatment for depressed patients and potentially, reduce high rates of recurrence. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA
| | - Apoorva Srinivasan
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Jaclyn S. Kirshenbaum
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - J. John Mann
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
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Auerbach RP. RDoC and the developmental origins of psychiatric disorders: How did we get here and where are we going? J Child Psychol Psychiatry 2022; 63:377-380. [PMID: 35133013 DOI: 10.1111/jcpp.13582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/12/2022] [Indexed: 11/28/2022]
Abstract
About a decade ago, the National Institute of Mental Health (NIMH) proposed an innovative framework, the Research Domain Criteria (RDoC), to classify psychiatric disorders. This complementary approach has been used with existing diagnostic systems to identify transdiagnostic factors that inform early detection of mental health disturbances and critically, provide novel targets for interventions. An additional goal, however, has been to clarify developmental processes and illness trajectories by operationalizing dimensional constructs during sensitive periods of neurofunctional development to capture the early emergence of behavioral alterations and impairment. As developmental factors are inherent to all RDoC systems and the units of analysis therein, NIMH shepherded developmental-oriented research with targeted funding opportunity announcements. This resulting work has highlighted promising phenotypes and biological markers related to psychiatric illness across the lifespan.
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Affiliation(s)
- Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA.,Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA.,Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
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33
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Auerbach RP, Pagliaccio D, Hubbard NA, Frosch I, Kremens R, Cosby E, Jones R, Siless V, Lo N, Henin A, Hofmann SG, Gabrieli JDE, Yendiki A, Whitfield-Gabrieli S, Pizzagalli DA. Reward-Related Neural Circuitry in Depressed and Anxious Adolescents: A Human Connectome Project. J Am Acad Child Adolesc Psychiatry 2022; 61:308-320. [PMID: 33965516 PMCID: PMC8643367 DOI: 10.1016/j.jaac.2021.04.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/17/2021] [Accepted: 04/26/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Although depression and anxiety often have distinct etiologies, they frequently co-occur in adolescence. Recent initiatives have underscored the importance of developing new ways of classifying mental illness based on underlying neural dimensions that cut across traditional diagnostic boundaries. Accordingly, the aim of the study was to clarify reward-related neural circuitry that may characterize depressed-anxious youth. METHOD The Boston Adolescent Neuroimaging of Depression and Anxiety Human Connectome Project tested group differences regarding subcortical volume and nucleus accumbens activation during an incentive processing task among 14- to 17-year-old adolescents presenting with a primary depressive and/or anxiety disorder (n = 129) or no lifetime history of mental disorders (n = 64). In addition, multimodal modeling examined predictors of depression and anxiety symptom change over a 6-month follow-up period. RESULTS Our findings highlighted considerable convergence. Relative to healthy youth, depressed-anxious adolescents exhibited reduced nucleus accumbens volume and activation following reward receipt. These findings remained when removing all medicated participants (∼59% of depressed-anxious youth). Subgroup analyses comparing anxious-only, depressed-anxious, and healthy youth also were largely consistent. Multimodal modeling showed that only structural alterations predicted depressive symptoms over time. CONCLUSION Multimodal findings highlight alterations within nucleus accumbens structure and function that characterize depressed-anxious adolescents. In the current hypothesis-driven analyses, however, only reduced nucleus accumbens volume predicted depressive symptoms over time. An important next step will be to clarify why structural alterations have an impact on reward-related processes and associated symptoms.
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Abstract
Suicide is a leading cause of death, and presently, there is no definitive clinical indicator of future suicide behaviors. Anhedonia, a transdiagnostic symptom reflecting diminished ability to experience pleasure, has recently emerged as a risk factor for suicidal thoughts and behaviors (STBs). This overview, therefore, has the following aims. First, prior research relating anhedonia to STBs will be reviewed, with a particular focus on clarifying whether anhedonia is more closely associated with suicidal thoughts versus behaviors. Second, the National Institute of Mental Health's Research Domain Criteria Positive Valence Systems provide a useful heuristic to probe anhedonia across different units of analysis, including clinical symptoms, behaviors, neural mechanisms, and molecular targets. Accordingly, anhedonia-related constructs linked to STBs will be detailed as well as promising next steps for future research. Third, although anhedonia is not directly addressed in leading suicide theories, this review will provide potential inroads to explore anhedonia within diathesis-stress and interpersonal suicide frameworks. Last, novel approaches to treat anhedonia as a means of reducing STBs will be examined.
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Affiliation(s)
- Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA.
- New York State Psychiatric Institute, New York, NY, USA.
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA.
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
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35
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Panchal P, de Queiroz Campos G, Goldman DA, Auerbach RP, Merikangas KR, Swartz HA, Sankar A, Blumberg HP. Toward a Digital Future in Bipolar Disorder Assessment: A Systematic Review of Disruptions in the Rest-Activity Cycle as Measured by Actigraphy. Front Psychiatry 2022; 13:780726. [PMID: 35677875 PMCID: PMC9167949 DOI: 10.3389/fpsyt.2022.780726] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Disruptions in rest and activity patterns are core features of bipolar disorder (BD). However, previous methods have been limited in fully characterizing the patterns. There is still a need to capture dysfunction in daily activity as well as rest patterns in order to more holistically understand the nature of 24-h rhythms in BD. Recent developments in the standardization, processing, and analyses of wearable digital actigraphy devices are advancing longitudinal investigation of rest-activity patterns in real time. The current systematic review aimed to summarize the literature on actigraphy measures of rest-activity patterns in BD to inform the future use of this technology. METHODS A comprehensive systematic review using PRISMA guidelines was conducted through PubMed, MEDLINE, PsycINFO, and EMBASE databases, for papers published up to February 2021. Relevant articles utilizing actigraphy measures were extracted and summarized. These papers contributed to three research areas addressed, pertaining to the nature of rest-activity patterns in BD, and the effects of therapeutic interventions on these patterns. RESULTS Seventy articles were included. BD was associated with longer sleep onset latency and duration, particularly during depressive episodes and with predictive value for worsening of future manic symptoms. Lower overall daily activity was also associated with BD, especially during depressive episodes, while more variable activity patterns within a day were seen in mania. A small number of studies linked these disruptions with differential patterns of brain functioning and cognitive impairments, as well as more adverse outcomes including increased suicide risk. The stabilizing effect of therapeutic options, including pharmacotherapies and chronotherapies, on activity patterns was supported. CONCLUSION The use of actigraphy provides valuable information about rest-activity patterns in BD. Although results suggest that variability in rhythms over time may be a specific feature of BD, definitive conclusions are limited by the small number of studies assessing longitudinal changes over days. Thus, there is an urgent need to extend this work to examine patterns of rhythmicity and regularity in BD. Actigraphy research holds great promise to identify a much-needed specific phenotypic marker for BD that will aid in the development of improved detection, treatment, and prevention options.
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Affiliation(s)
- Priyanka Panchal
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | | | - Danielle A Goldman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT, United States
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, United States
| | - Holly A Swartz
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Anjali Sankar
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Department of Radiology and Biomedical Imaging, and the Child Study Center, Yale School of Medicine, New Haven, CT, United States
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36
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Karyotaki E, Klein AM, Ciharova M, Bolinski F, Krijnen L, de Koning L, de Wit L, van der Heijde CM, Ebert DD, Riper H, Batelaan N, Vonk P, Auerbach RP, Kessler RC, Bruffaerts R, Struijs S, Wiers RW, Cuijpers P. Guided internet-based transdiagnostic individually tailored Cognitive Behavioral Therapy for symptoms of depression and/or anxiety in college students: A randomized controlled trial. Behav Res Ther 2022; 150:104028. [DOI: 10.1016/j.brat.2021.104028] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 12/17/2021] [Accepted: 12/27/2021] [Indexed: 12/22/2022]
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Allison GO, Kamath RA, Carrillo V, Alqueza KL, Pagliaccio D, Slavich GM, Shankman SA, Auerbach RP. Self-referential Processing in Remitted Depression: An Event-Related Potential Study. Biol Psychiatry Glob Open Sci 2021; 3:119-129. [PMID: 36712564 PMCID: PMC9874080 DOI: 10.1016/j.bpsgos.2021.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/10/2021] [Accepted: 12/12/2021] [Indexed: 02/01/2023] Open
Abstract
Background Identifying mechanisms of major depressive disorder that continue into remission is critical, as these mechanisms may contribute to subsequent depressive episodes. Biobehavioral markers related to depressogenic self-referential processing biases have been identified in adults with depression. Thus, we investigated whether these risk factors persisted during remission as well as contributed to the occurrence of stress and depressive symptoms over time. Methods At baseline, adults with remitted depression (n = 33) and healthy control subjects (n = 33) were administered diagnostic and stress interviews as well as self-report symptom measures. In addition, participants completed a self-referential encoding task while electroencephalography data were acquired. Stress interviews and self-report symptom measures were readministered at the 6-month follow-up assessment. Results Drift diffusion modeling showed that compared with healthy individuals, adults with remitted depression exhibited a slower drift rate to negative stimuli, indicating a slower tendency to reject negative stimuli as self-relevant. At the 6-month follow-up assessment, a slower drift rate to negative stimuli predicted greater interpersonal stress severity among individuals with remitted depression but not healthy individuals while controlling for both baseline depression symptoms and interpersonal stress severity. Highlighting the specificity of this effect, results were nonsignificant when predicting noninterpersonal stress. For self-relevant positive words endorsed, adults with remitted depression exhibited smaller left- than right-hemisphere late positive potential amplitudes; healthy control subjects did not show hemispheric differences. Conclusions Self-referential processing deficits persist into remission. In line with the stress generation framework, these biases predicted the occurrence of interpersonal stress, which may provide insight about a potential pathway for the re-emergence of depressive symptoms.
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Affiliation(s)
- Grace O. Allison
- Department of Psychiatry, Columbia University, New York, New York
| | - Rahil A. Kamath
- Department of Psychiatry, Columbia University, New York, New York
| | - Vivian Carrillo
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, Illinois
| | - Kira L. Alqueza
- Department of Psychiatry, Columbia University, New York, New York
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, New York
| | - George M. Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Stewart A. Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, Illinois
| | - Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, New York,Division of Clinical Developmental Neuroscience, Sackler Institute, New York, New York,Address correspondence to Randy P. Auerbach, Ph.D.
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38
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Maffei C, Lee C, Planich M, Ramprasad M, Ravi N, Trainor D, Urban Z, Kim M, Jones RJ, Henin A, Hofmann SG, Pizzagalli DA, Auerbach RP, Gabrieli JDE, Whitfield-Gabrieli S, Greve DN, Haber SN, Yendiki A. Using diffusion MRI data acquired with ultra-high gradient strength to improve tractography in routine-quality data. Neuroimage 2021; 245:118706. [PMID: 34780916 PMCID: PMC8835483 DOI: 10.1016/j.neuroimage.2021.118706] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/11/2021] [Accepted: 11/01/2021] [Indexed: 11/27/2022] Open
Abstract
The development of scanners with ultra-high gradient strength, spearheaded by the Human Connectome Project, has led to dramatic improvements in the spatial, angular, and diffusion resolution that is feasible for in vivo diffusion MRI acquisitions. The improved quality of the data can be exploited to achieve higher accuracy in the inference of both microstructural and macrostructural anatomy. However, such high-quality data can only be acquired on a handful of Connectom MRI scanners worldwide, while remaining prohibitive in clinical settings because of the constraints imposed by hardware and scanning time. In this study, we first update the classical protocols for tractography-based, manual annotation of major white-matter pathways, to adapt them to the much greater volume and variability of the streamlines that can be produced from today’s state-of-the-art diffusion MRI data. We then use these protocols to annotate 42 major pathways manually in data from a Connectom scanner. Finally, we show that, when we use these manually annotated pathways as training data for global probabilistic tractography with anatomical neighborhood priors, we can perform highly accurate, automated reconstruction of the same pathways in much lower-quality, more widely available diffusion MRI data. The outcomes of this work include both a new, comprehensive atlas of WM pathways from Connectom data, and an updated version of our tractography toolbox, TRActs Constrained by UnderLying Anatomy (TRACULA), which is trained on data from this atlas. Both the atlas and TRACULA are distributed publicly as part of FreeSurfer. We present the first comprehensive comparison of TRACULA to the more conventional, multi-region-of-interest approach to automated tractography, and the first demonstration of training TRACULA on high-quality, Connectom data to benefit studies that use more modest acquisition protocols.
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Affiliation(s)
- C Maffei
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.
| | - C Lee
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - M Planich
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - M Ramprasad
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - N Ravi
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - D Trainor
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Z Urban
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - M Kim
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - R J Jones
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - A Henin
- Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - S G Hofmann
- Department of Clinical Psychology, Philipps University Marburg, Germany; Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - D A Pizzagalli
- McLean Hospital and Harvard Medical School, Belmont, MA, USA
| | | | - J D E Gabrieli
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | - D N Greve
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - S N Haber
- McLean Hospital and Harvard Medical School, Belmont, MA, USA; Department of Pharmacology and Physiology, University of Rochester School of Medicine, Rochester, NY, USA
| | - A Yendiki
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
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Jones LB, Judkowicz C, Hudec KL, Munthali RJ, Prescivalli AP, Wang AY, Munro L, Xie H, Pendakur K, Rush B, Gillett J, Young M, Singh D, Todorova AA, Auerbach RP, Bruffaerts R, Gildea SM, McKechnie I, Gadermann A, Richardson CG, Sampson NA, Kessler RC, Vigo DV. The World Mental Health-International College Student (WMH-ICS) Survey in Canada: Protocol for a Mental Health and Substance Use Trend Study (Preprint). JMIR Res Protoc 2021; 11:e35168. [PMID: 35696337 PMCID: PMC9377443 DOI: 10.2196/35168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 05/13/2022] [Accepted: 06/03/2022] [Indexed: 11/18/2022] Open
Abstract
Background The World Health Organization World Mental Health International College Student (WMH-ICS) initiative aims to screen for mental health and substance use problems among postsecondary students on a global scale as well as to develop and evaluate evidence-based preventive and ameliorative interventions for this population. This protocol paper presents the Canadian version of the WMH-ICS survey, detailing the adapted survey instrument, the unique weekly cross-sectional administration, the multitiered recruitment strategy, and the associated risk mitigation protocols. Objective This paper aims to provide a methodological resource for researchers conducting cross-national comparisons of WMH-ICS data, as well as to serve as a useful guide for those interested in replicating the outlined cross-sectional methodology to better understand how mental health and substance use vary over time among university students. Methods The online survey is based on the WMH-ICS survey instrument, modified to the Canadian context by the addition of questions pertaining to Canadian-based guidelines and the translation of the survey to Canadian French. The survey is administered through the Qualtrics survey platform and is sent to an independent stratified random sample of 350 students per site weekly, followed by two reminder emails. Upon survey closure every week, a random subsample of 70 nonresponders are followed up with via phone or through a personal email in an effort to decrease nonresponder bias. The survey is accompanied by an extensive risk mitigation protocol that stratifies respondents by the level of need and provides tailored service recommendations, including a facilitated expedited appointment to student counseling services for those at increased risk of suicide. The anticipated sample size is approximately 5500 students per site per year. Results In February 2020, the Canadian survey was deployed at the University of British Columbia. This was followed by deployment at Simon Fraser University (November 2020), McMaster University (January 2021), and the University of Toronto (January 2022). Data collection at all 4 sites is ongoing. As of May 6, 2022, 29,503 responses have been collected. Conclusions Based on international collaboration, the Canadian version of the WMH-ICS survey incorporates a novel methodological approach centered on the weekly administration of a comprehensive cross-sectional survey to independent stratified random samples of university students. After 27 months of consecutive survey administration, we have developed and refined a survey protocol that has proven effective in engaging students at four Canadian institutions, allowing us to track how mental health and substance use vary over time using an internationally developed university student survey based on the criteria from the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). International Registered Report Identifier (IRRID) RR1-10.2196/35168
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Affiliation(s)
- Laura B Jones
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Carolina Judkowicz
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kristen L Hudec
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Richard J Munthali
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Ana Paula Prescivalli
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Angel Y Wang
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Lonna Munro
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Hui Xie
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Krishna Pendakur
- Department of Economics, Simon Fraser University, Burnaby, BC, Canada
| | - Brian Rush
- Social & Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - James Gillett
- Department of Health, Aging & Society, Faculty of Social Sciences, McMaster University, Hamilton, ON, Canada
| | - Marisa Young
- Department of Sociology, Faculty of Social Sciences, McMaster University, Hamilton, ON, Canada
| | - Diana Singh
- Department of Sociology, Faculty of Social Sciences, McMaster University, Hamilton, ON, Canada
| | | | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Sarah M Gildea
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
| | - Irene McKechnie
- Okanagan Planning and Institutional Research, University of British Columbia, Kelowna, BC, Canada
| | - Anne Gadermann
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Chris G Richardson
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
| | - Daniel V Vigo
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Umemoto A, Cole SL, Allison GO, Dolan S, Lazarov A, Auerbach RP, Schneier F. Neurophysiological predictors of gaze-contingent music reward therapy among adults with social anxiety disorder. J Psychiatr Res 2021; 143:155-162. [PMID: 34487992 PMCID: PMC8557124 DOI: 10.1016/j.jpsychires.2021.09.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/29/2021] [Accepted: 09/01/2021] [Indexed: 11/19/2022]
Abstract
Social anxiety disorder (SAD) is associated with fear of negative evaluation and heightened performance monitoring. The best-established treatments help only a subset of patients, and there are no well-established predictors of treatment response. The current study investigated whether individual differences in processing errors might predict response to gaze-contingent music reward therapy (GC-MRT). At baseline, healthy control subjects (HC; n = 20) and adults with SAD (n = 29), ages 19-43 years, completed the Flanker Task while electroencephalography (EEG) data were recorded. SAD participants then received up to 12 sessions over 8 weeks of GC-MRT, designed to train participants' attention away from threatening and toward neutral faces. Clinical assessments were completed 9- (post-treatment) and 20-weeks (follow-up) after initiating the treatment. At baseline, compared to HC, SAD performed the task more accurately and exhibited increased error-related negativity (ERN) and delta power to error commission. After controlling for age and baseline symptoms, more negative ERN and increased frontal midline theta (FMT) predicted reduced self-reported social anxiety symptoms at post-treatment, and FMT also predicted clinician-rated and self-reported symptom reduction at the follow-up assessment. Hypervigilance to error is characteristic of SAD and warrants further research as a predictor of treatment response for GC-MRT.
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Affiliation(s)
- Akina Umemoto
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Sally L Cole
- Department of Psychiatry, Columbia University, New York, NY, USA
| | | | - Sarah Dolan
- New York State Psychiatric Institute, New York, NY, USA
| | - Amit Lazarov
- School of Psychological Sciences, Tel Aviv University, Tel-Aviv, Israel
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA; Division of Clinical Developmental Neuroscience, Sackler Institute, USA
| | - Franklin Schneier
- Department of Psychiatry, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA.
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Chase HW, Auerbach RP, Brent DA, Posner J, Weissman MM, Talati A. Dissociating default mode network resting state markers of suicide from familial risk factors for depression. Neuropsychopharmacology 2021; 46:1830-1838. [PMID: 34059799 PMCID: PMC8358011 DOI: 10.1038/s41386-021-01022-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 04/14/2021] [Accepted: 04/17/2021] [Indexed: 11/09/2022]
Abstract
Neural signatures of suicide risk likely reflect a combination of specific and non-specific factors, and clarifying specific factors may facilitate development of novel treatments. Previously, we demonstrated an altered pattern of resting state connectivity between the dorsal and ventral posterior cingulate cortex (d/vPCC) and the dorsal anterior cingulate cortex (dACC), as well as altered low frequency oscillations in these regions, in individuals with a history of suicidal thoughts and behaviors (STBs) compared to healthy controls. It remains uncertain, however, whether these markers were directly related to STBs or, more generally, reflect a trait-level risk factor for depression. Here, we examined data from a 3-generational longitudinal study of depression where resting state fMRI data were analyzed from 2nd and 3rd generation offspring of probands with (FH+ = 44: STB+ = 32, STB- = 12) and without (FH- = 25: STB+ = 15, STB- = 10) a family history of major depressive disorder (MDD). Standard seed-based methods and a frequency-based analysis of intrinsic neural activity (ALFF/fALFF) were employed. FH of MDD, but not a personal history of STBs or MDD, was associated with relatively reduced dPCC-dACC, and enhanced vPCC-dACC functional connectivity. FH of MDD showed a pattern of reduced ALFF in the dPCC whereas an STB history was associated with an increase. All findings were invariant to confounding by lifetime MDD and current depression severity. Overall, contrary to predictions, resting state functional connectivity within the default mode network (DMN) was associated with FH of depression rather than STBs. These findings confirm the relevance of DMN functional connectivity for mood disorders and underscore the importance of disambiguating biological factors that differentially relate to mental disorders versus STBs.
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Affiliation(s)
- Henry W. Chase
- grid.21925.3d0000 0004 1936 9000Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - Randy P. Auerbach
- grid.21729.3f0000000419368729Department of Psychiatry, Columbia University Irving Medical Center and Vagelos College of Physicians and Surgeons, New York, NY USA ,grid.413734.60000 0000 8499 1112New York State Psychiatric Institute, New York, NY USA ,grid.21729.3f0000000419368729Sackler Institute for Developmental Psychobiology at Columbia University, New York, NY USA
| | - David A. Brent
- grid.21925.3d0000 0004 1936 9000Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - Jonathan Posner
- grid.21729.3f0000000419368729Department of Psychiatry, Columbia University Irving Medical Center and Vagelos College of Physicians and Surgeons, New York, NY USA ,grid.413734.60000 0000 8499 1112New York State Psychiatric Institute, New York, NY USA ,grid.21729.3f0000000419368729Sackler Institute for Developmental Psychobiology at Columbia University, New York, NY USA
| | - Myrna M. Weissman
- grid.21729.3f0000000419368729Department of Psychiatry, Columbia University Irving Medical Center and Vagelos College of Physicians and Surgeons, New York, NY USA ,grid.413734.60000 0000 8499 1112New York State Psychiatric Institute, New York, NY USA ,grid.21729.3f0000000419368729Sackler Institute for Developmental Psychobiology at Columbia University, New York, NY USA ,grid.21729.3f0000000419368729Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY USA
| | - Ardesheer Talati
- Department of Psychiatry, Columbia University Irving Medical Center and Vagelos College of Physicians and Surgeons, New York, NY, USA. .,New York State Psychiatric Institute, New York, NY, USA. .,Sackler Institute for Developmental Psychobiology at Columbia University, New York, NY, USA.
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Vigo D, Jones L, Munthali R, Pei J, Westenberg J, Munro L, Judkowicz C, Wang AY, Van den Adel B, Dulai J, Krausz M, Auerbach RP, Bruffaerts R, Yatham L, Gadermann A, Rush B, Xie H, Pendakur K, Richardson C. [Association of COVID-19 dissemination with symptoms of anxiety and depression among university students]. Vertex 2021; XXXII:53-69. [PMID: 34783787 DOI: 10.53680/vertex.v32i153.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Evidence about the impact of the COVID-19 pandemic on the mental health of specific subpopulations- such as university students-is needed as communities prepare for future waves. AIMS To study the association of proximity of COVID-19 with symptoms of anxiety and depression in university students. METHODS This trend study analyzed weekly cross-sectional surveys of probabilistic samples of students from the University of British Columbia for 13 weeks through the first wave of COVID-19. The main variable assessed was propinquity of COVID-19, defined as "knowing someone who tested positive for COVID-19", which was specified at different levels: knowing someone anywhere globally, in Canada, in Vancouver, in their course, or at home. Proximity was included in multivariable linear regressions to assess its association with primary outcomes, including 30-day symptoms of anxiety and/or depression. RESULTS Of 1,388 respondents (adjusted response rate=50%), 5.6% knew someone with COVID-19 in Vancouver, 0.8% in their course, and 0.3% at home. Ten percent were overwhelmed and unable to access help. Knowing someone in Vancouver was associated with an 11 percentage-point increase in the probability of 30-day anxiety symptoms (SE=0,05; p≤0,05), moderated by gender, with a significant interaction of the exposure and being female (coefficient= 20(SE=0,09), p≤0,05). No association was found with depressive symptoms. CONCLUSION Propinquity of COVID-19 cases may increase the likelihood of anxiety symptoms in students, particularly amongst men. Most students report coping well, but additional supports are needed for an emotionally overwhelmed minority who report being unable to access help.
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Affiliation(s)
- Daniel Vigo
- Department of Psychiatry, University of British Columbia, Canada. E-mail:
| | - Laura Jones
- Department of Psychiatry, University of British Columbia, Canada
| | - Richard Munthali
- Department of Psychiatry, University of British Columbia, Canada
| | - Julia Pei
- Department of Psychiatry, University of British Columbia, Canada
| | - Jean Westenberg
- Department of Psychiatry, University of British Columbia, Canada
| | - Lonna Munro
- Department of Psychiatry, University of British Columbia, Canada
| | | | - Angel Y Wang
- Department of Psychiatry, University of British Columbia, Canada
| | | | - Joshun Dulai
- Department of Psychiatry, University of British Columbia, Canada
| | - Michael Krausz
- Department of Psychiatry, University of British Columbia, Canada
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, United States
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum KU Leuven, Belgium
| | - Lakshmi Yatham
- Department of Psychiatry, University of British Columbia, Canada
| | - Anne Gadermann
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Brian Rush
- Department of Psychiatry & School of Public Health, University of Toronto, Toronto, Canada
| | - Hui Xie
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Krishna Pendakur
- Department of Economics, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Chris Richardson
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
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Gericke F, Ebert DD, Breet E, Auerbach RP, Bantjes J. A qualitative study of university students' experience of Internet‐based CBT for depression. Couns Psychother Res 2021. [DOI: 10.1002/capr.12465] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Franco Gericke
- Institute for Life Course Health Research Department of Global Health Faculty of Medicine and Health Sciences Stellenbosch University Stellenbosch South Africa
| | - David D. Ebert
- Psychology & Digital Mental Health Care, Department of Sport and Health Sciences Technical University Munich Munich Germany
| | - Elsie Breet
- Institute for Life Course Health Research Department of Global Health Faculty of Medicine and Health Sciences Stellenbosch University Stellenbosch South Africa
| | | | - Jason Bantjes
- Institute for Life Course Health Research Department of Global Health Faculty of Medicine and Health Sciences Stellenbosch University Stellenbosch South Africa
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Abstract
OBJECTIVE The authors sought to identify scalable evidence-based suicide prevention strategies. METHODS A search of PubMed and Google Scholar identified 20,234 articles published between September 2005 and December 2019, of which 97 were randomized controlled trials with suicidal behavior or ideation as primary outcomes or epidemiological studies of limiting access to lethal means, using educational approaches, and the impact of antidepressant treatment. RESULTS Training primary care physicians in depression recognition and treatment prevents suicide. Educating youths on depression and suicidal behavior, as well as active outreach to psychiatric patients after discharge or a suicidal crisis, prevents suicidal behavior. Meta-analyses find that antidepressants prevent suicide attempts, but individual randomized controlled trials appear to be underpowered. Ketamine reduces suicidal ideation in hours but is untested for suicidal behavior prevention. Cognitive-behavioral therapy and dialectical behavior therapy prevent suicidal behavior. Active screening for suicidal ideation or behavior is not proven to be better than just screening for depression. Education of gatekeepers about youth suicidal behavior lacks effectiveness. No randomized trials have been reported for gatekeeper training for prevention of adult suicidal behavior. Algorithm-driven electronic health record screening, Internet-based screening, and smartphone passive monitoring to identify high-risk patients are understudied. Means restriction, including of firearms, prevents suicide but is sporadically employed in the United States, even though firearms are used in half of all U.S. suicides. CONCLUSIONS Training general practitioners warrants wider implementation and testing in other nonpsychiatrist physician settings. Active follow-up of patients after discharge or a suicide-related crisis should be routine, and restricting firearm access by at-risk individuals warrants wider use. Combination approaches in health care systems show promise in reducing suicide in several countries, but evaluating the benefit attributable to each component is essential. Further suicide rate reduction requires evaluating newer approaches, such as electronic health record-derived algorithms, Internet-based screening methods, ketamine's potential benefit for preventing attempts, and passive monitoring of acute suicide risk change.
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Affiliation(s)
- J. John Mann
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, and Department of Psychiatry and Radiology, Columbia University, New York, NY
| | - Christina A. Michel
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
| | - Randy P. Auerbach
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, and Department of Psychiatry, Columbia University, New York, NY,Division of Clinical Developmental Neuroscience, Sackler Institute
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Affiliation(s)
- Randy P. Auerbach
- Department of Psychiatry, Columbia University Irving Medical Center and Vagelos College of Physicians and Surgeons, New York, NY
| | - Henry W. Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - David A. Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA,Corresponding Author: David A. Brent, MD, University of Pittsburgh School of Medicine, Western Psychiatric Hospital of the University of Pittsburgh Medical Center, 3811 O’Hara St. BFT 311, Pittsburgh PA., 15213;
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46
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Vigo D, Jones L, Munthali R, Pei J, Westenberg J, Munro L, Judkowicz C, Wang AY, Van den Adel B, Dulai J, Krausz M, Auerbach RP, Bruffaerts R, Yatham L, Gadermann A, Rush B, Xie H, Pendakur K, Richardson C. Investigating the effect of COVID-19 dissemination on symptoms of anxiety and depression among university students. BJPsych Open 2021; 7:e69. [PMID: 33736744 PMCID: PMC8058823 DOI: 10.1192/bjo.2021.24] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/08/2021] [Accepted: 02/19/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Evidence about the impact of the COVID-19 pandemic on the mental health of specific subpopulations, such as university students, is needed as communities prepare for future waves. AIMS To study the association of proximity of COVID-19 with symptoms of anxiety and depression in university students. METHOD This trend study analysed weekly cross-sectional surveys of probabilistic samples of students from the University of British Columbia for 13 weeks, through the first wave of COVID-19. The main variable assessed was propinquity of COVID-19, defined as 'knowing someone who tested positive for COVID-19', which was specified at different levels: knowing someone anywhere globally, in Canada, in Vancouver, in their course or at home. Proximity was included in multivariable linear regressions to assess its association with primary outcomes, including 30-day symptoms of anxiety and/or depression. RESULTS Of 1388 respondents (adjusted response rate of 50%), 5.6% knew someone with COVID-19 in Vancouver, 0.8% in their course and 0.3% at home. Ten percent were overwhelmed and unable to access help. Knowing someone in Vancouver was associated with an 11-percentage-point increase in the probability of 30-day anxiety symptoms (s.e. 0.05, P ≤ 0.05), moderated by gender, with a significant interaction of the exposure and being female (coefficient -20, s.e. 0.09, P ≤ 0.05). No association was found with depressive symptoms. CONCLUSIONS Propinquity of COVID-19 cases may increase the likelihood of anxiety symptoms in students, particularly among men. Most students reported coping well, but additional support is needed for an emotionally overwhelmed minority who report being unable to access help.
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Affiliation(s)
- Daniel Vigo
- Department of Psychiatry, University of British Columbia, Canada
| | - Laura Jones
- Department of Psychiatry, University of British Columbia, Canada
| | - Richard Munthali
- Department of Psychiatry, University of British Columbia, Canada
| | - Julia Pei
- Department of Psychiatry, University of British Columbia, Canada
| | - Jean Westenberg
- Department of Psychiatry, University of British Columbia, Canada
| | - Lonna Munro
- Department of Psychiatry, University of British Columbia, Canada
| | | | - Angel Y. Wang
- Department of Psychiatry, University of British Columbia, Canada
| | | | - Joshun Dulai
- Department of Psychiatry, University of British Columbia, Canada
| | - Michael Krausz
- Department of Psychiatry, University of British Columbia, Canada
| | | | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum KU Leuven, Belgium
| | - Lakshmi Yatham
- Department of Psychiatry, University of British Columbia, Canada
| | - Anne Gadermann
- School of Population and Public Health, University of British Columbia, Canada
| | - Brian Rush
- Department of Psychiatry & School of Public Health, University of Toronto, Canada
| | - Hui Xie
- Faculty of Health Sciences, Simon Fraser University, Canada
| | | | - Chris Richardson
- School of Population and Public Health, University of British Columbia, Canada
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47
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Funkhouser CJ, Kaiser AJE, Alqueza KL, Carrillo VL, Hoffman LMK, Nabb CB, Auerbach RP, Shankman SA. Depression risk factors and affect dynamics: An experience sampling study. J Psychiatr Res 2021; 135:68-75. [PMID: 33450467 PMCID: PMC7914176 DOI: 10.1016/j.jpsychires.2021.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/05/2020] [Accepted: 01/04/2021] [Indexed: 01/22/2023]
Abstract
Affect dynamics reflect individual differences in how emotional information is processed, and may provide insights into how depressive episodes develop. To extend prior studies that examined affect dynamics in currently depressed individuals, the present study tested in 68 non-depressed young adults whether three well-established risk factors for major depressive disorder (MDD) - (a) past episodes of MDD, (b) family history of MDD, and (c) reduced neurophysiological responses to reward - predicted mean levels, instability, or inertia (i.e., inflexibility) of positive affect (PA) and/or negative affect (NA). Momentary PA and NA were assessed up to 6 times per day for 14 days (mean number of surveys completed = 45.89). MDD history and family history of MDD were assessed via semi-structured interview, and neurophysiological responses to reward were indexed using the Reward Positivity, an event-related potential related to depression. After adjusting for current depressive symptoms, results indicated that (a) past episodes of MDD predicted higher mean levels of NA, (b) family history of MDD predicted greater PA inertia, and (c) blunted reactivity to reward predicted greater NA inertia. Collectively, these results suggest that elevated mean levels of NA and inflexibility of PA and NA may be potential mechanisms that confer risk for depression.
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Affiliation(s)
- Carter J Funkhouser
- Northwestern University, Department of Psychiatry and Behavioral Sciences, 680 N. Lake Shore Drive, Chicago, IL, 60611, USA; University of Illinois at Chicago, Department of Psychology, 1007 W. Harrison Street, Chicago, IL, 60607, USA
| | - Ariela J E Kaiser
- University of Illinois at Chicago, Department of Psychology, 1007 W. Harrison Street, Chicago, IL, 60607, USA
| | - Kira L Alqueza
- Columbia University, Department of Psychiatry, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Vivian L Carrillo
- Northwestern University, Department of Psychiatry and Behavioral Sciences, 680 N. Lake Shore Drive, Chicago, IL, 60611, USA
| | - Lija M K Hoffman
- Northwestern University, Department of Psychiatry and Behavioral Sciences, 680 N. Lake Shore Drive, Chicago, IL, 60611, USA
| | - Carver B Nabb
- Northwestern University, Department of Psychiatry and Behavioral Sciences, 680 N. Lake Shore Drive, Chicago, IL, 60611, USA
| | - Randy P Auerbach
- Columbia University, Department of Psychiatry, 1051 Riverside Drive, New York, NY, 10032, USA; Sackler Institute, Division of Clinical Developmental Neuroscience, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Stewart A Shankman
- Northwestern University, Department of Psychiatry and Behavioral Sciences, 680 N. Lake Shore Drive, Chicago, IL, 60611, USA.
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Rentería R, Benjet C, Gutierrez-Garcia RA, Ábrego Ramírez A, Albor Y, Borges G, Covarrubias Díaz Couder MA, Durán MDS, González González R, Guzmán Saldaña R, Hermosillo De la Torre AE, Martínez-Jerez AM, Martinez Martinez KI, Medina-Mora ME, Martínez Ruiz S, Paz Pérez MA, Pérez Tarango G, Zavala Berbena MA, Méndez E, Auerbach RP, Mortier P. Suicide thought and behaviors, non-suicidal self-injury, and perceived life stress among sexual minority Mexican college students. J Affect Disord 2021; 281:891-898. [PMID: 33243555 PMCID: PMC7856251 DOI: 10.1016/j.jad.2020.11.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 10/13/2020] [Accepted: 11/07/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Sexual minority college students are at a higher risk for suicidal thoughts and self-injurious behaviors compared to heterosexual students. Minority stress theory proposes sexual minority individuals experience higher stress due to stigma. Using a sample of Mexican college students, this study tested perceived life stress as a mediator of suicide and self-injury outcomes across various sexual orientation groups. METHODS The sample of college students (N=7882) was recruited from nine Mexican universities as part of the WHO World Mental Health International College Student (WMH-ICS) initiative. Participants completed an online survey including demographic questions, measure of perceived life stress, suicide outcomes, and non-suicidal self-injury (NSSI) in the past 12 months. RESULTS Logistic regression analyses revealed identifying as a sexual minority significantly predicted a higher likelihood of suicide ideation (ORs 2.05-3.00), suicide attempts (ORs 2.48-8.73), and NSSI (ORs 2.92-4.18) compared to heterosexual students reporting no same-gender attraction. Significant indirect effects from mediation path analyses showed perceived life stress mediated the relationship between a sexual minority identity and suicide ideation (range of proportion mediated 10.48-31.48%), attempts (10.48-31.48%), and NSSI (7.69-20.09%) across each group except among asexual students. LIMITATIONS The cross-sectional nature of the survey design precludes drawing causal inferences. CONCLUSION Findings from this study contribute to minority stress theory by elucidating the role of perceived life stress as a mediator of suicide ideation and attempts and NSSI among sexual minority college students. Clinical interventions may benefit in focusing on experiences of stress across various life areas when supporting sexual minority college students.
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Affiliation(s)
- Roberto Rentería
- Counseling & Counseling Psychology, Arizona State University, Tempe, Arizona, United States of America
| | - Corina Benjet
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México.
| | - Raúl A Gutierrez-Garcia
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Campus Salamanca, Salamanca, Guanajuato, México
| | - Adrián Ábrego Ramírez
- Dirección de Investigación, Universidad Politécnica de Aguascalientes, Aguascalientes, Aguascalientes, México; Dirección de Educación a Distancia, Universidad Cuauhtémoc, Plantel Aguascalientes, Aguascalientes, Aguascalientes, México
| | - Yesica Albor
- Departamento de Salud Púbica, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Guilherme Borges
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | | | - María Del Socorro Durán
- Dirección de Orientación y Desarrollo Educativo, Universidad De La Salle Bajío, Campus Campestre, León, Guanajuato, México
| | - Rogaciano González González
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Campus Salamanca, Salamanca, Guanajuato, México
| | - Rebeca Guzmán Saldaña
- Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Hidalgo, México
| | | | - Ana María Martínez-Jerez
- Facultad de Derecho y Ciencias Sociales, Universidad Autónoma de Tamaulipas. Tampico, Tamaulipas, México
| | - Kalina I Martinez Martinez
- Departamento de Psicología, Universidad Autónoma de Aguascalientes, Aguascalientes, Aguascalientes, México
| | - María Elena Medina-Mora
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | | | - María Abigail Paz Pérez
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Campus Salamanca, Salamanca, Guanajuato, México
| | - Gustavo Pérez Tarango
- Dirección de Orientación y Desarrollo Educativo, Universidad De La Salle Bajío, Campus Campestre, León, Guanajuato, México
| | - María Alicia Zavala Berbena
- Dirección de Orientación y Desarrollo Educativo, Universidad De La Salle Bajío, Campus Campestre, León, Guanajuato, México
| | - Enrique Méndez
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York City, New York, USA
| | - Philippe Mortier
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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Rentería R, Benjet C, Gutiérrez-García RA, Abrego-Ramírez A, Albor Y, Borges G, Covarrubias Díaz-Couder MA, Durán MDS, González-González R, Guzmán Saldaña R, E Hermosillo De la Torre A, Martínez-Jerez AM, Martinez Martinez KI, Medina-Mora ME, Martínez Ruiz S, Paz Pérez MA, Pérez Tarango G, Zavala Berbena MA, Méndez E, Auerbach RP, Mortier P. Prevalence of 12-month mental and substance use disorders in sexual minority college students in Mexico. Soc Psychiatry Psychiatr Epidemiol 2021; 56:247-257. [PMID: 32886133 DOI: 10.1007/s00127-020-01943-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 08/07/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE Mental health disparities have been documented among sexual minority college students, but there is a dearth of evidence from developing countries. The aim is to estimate the prevalence of 12-month mental and substance use disorders across a range of sexual identities among first-year college students in Mexican universities, and test whether there is an association between sexual identity and disorders and whether the association is moderated by gender. METHOD The University Project for Healthy Students, a web-based survey conducted as part of the World Health Organization's World Mental Health International College Student initiative, recruited 7874 students from nine Mexican universities in 2016 and 2017. Logistic regressions estimated the association of sexual identity with 12-month major depressive episode, generalized anxiety disorder, panic disorder, alcohol abuse/dependence, and drug abuse/dependence, with interaction terms for gender. RESULTS Compared to heterosexual students reporting no same-sex attraction (SSA), heterosexual students with SSA (AORs range 1.77-3.67) and lesbian/gay and bisexual students (AORs range 2.22-5.32) were at a higher risk for several disorders. Asexual students were at higher risk for drug abuse/dependence (AOR = 3.64). Students unsure of their sexual identity were at a higher risk for major depressive episode, panic disorder, and drug abuse/dependence (AORs range 2.25-3.82). Gender differences varied across sexual identity and disorder. CONCLUSION These findings are the first empirical report of sexual minority psychiatric disparities among a college student population from a developing nation and underscore the importance of clinical interventions that address mental health needs among sexual minority college students.
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Affiliation(s)
- Roberto Rentería
- Counseling & Counseling Psychology, Arizona State University, Tempe, Arizona, USA
| | - Corina Benjet
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad De México, Mexico.
| | - Raúl A Gutiérrez-García
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Campus Salamanca, Salamanca, Guanajuato, Mexico
| | - Adrián Abrego-Ramírez
- Dirección de Investigación, Universidad Politécnica de Aguascalientes, Aguascalientes, Aguascalientes, Mexico.,Dirección de Educación a Distancia, Universidad Cuauhtémoc, Plantel Aguascalientes, Aguascalientes, Mexico
| | - Yesica Albor
- Departamento de Salud Púbica, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad De México, Mexico
| | - Guilherme Borges
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad De México, Mexico
| | | | - María Del Socorro Durán
- Dirección de Orientación y Desarrollo Educativo, Universidad De La Salle Bajío, Campus Campestre, León, Guanajuato, Mexico
| | - Rogaciano González-González
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Campus Salamanca, Salamanca, Guanajuato, Mexico
| | - Rebeca Guzmán Saldaña
- Instituto de Ciencias de la Salud y Coordinación de Investigación, Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, Mexico
| | | | - Ana María Martínez-Jerez
- Unidad Académica de Ciencias Jurídicas y Sociales, Universidad Autónoma de Tamaulipas, Ciudad Victoria, Tamaulipas, Mexico
| | - Kalina I Martinez Martinez
- Departamento de Psicología, Universidad Autónoma de Aguascalientes, Aguascalientes, Aguascalientes, Mexico
| | - María Elena Medina-Mora
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad De México, Mexico
| | | | - María Abigail Paz Pérez
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Campus Salamanca, Salamanca, Guanajuato, Mexico
| | - Gustavo Pérez Tarango
- Dirección de Orientación y Desarrollo Educativo, Universidad De La Salle Bajío, Campus Campestre, León, Guanajuato, Mexico
| | | | - Enrique Méndez
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad De México, Mexico
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York City, NY, USA
| | - Philippe Mortier
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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Auerbach RP, Pagliaccio D, Allison GO, Alqueza KL, Alonso MF. Neural Correlates Associated With Suicide and Nonsuicidal Self-injury in Youth. Biol Psychiatry 2021; 89:119-133. [PMID: 32782140 PMCID: PMC7726029 DOI: 10.1016/j.biopsych.2020.06.002] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/31/2020] [Accepted: 06/01/2020] [Indexed: 12/23/2022]
Abstract
There is no definitive neural marker of suicidal thoughts and behaviors (STBs) or nonsuicidal self-injury (NSSI), and relative to adults, research in youth is more limited. This comprehensive review focuses on magnetic resonance imaging studies reporting structural and functional neural correlates of STBs and NSSI in youth to 1) elucidate shared and independent neural alternations, 2) clarify how developmental processes may interact with neural alterations to confer risk, and 3) provide recommendations based on convergence across studies. Forty-seven articles were reviewed (STBs = 27; NSSI = 20), and notably, 63% of STB articles and 45% of NSSI articles were published in the previous 3 years. Structural magnetic resonance imaging research suggests reduced volume in the ventral prefrontal and orbitofrontal cortices among youth reporting STBs, and there is reduced anterior cingulate cortex volume related to STBs and NSSI. With regard to functional alterations, blunted striatal activation may characterize STB and NSSI youth, and there is reduced frontolimbic task-based connectivity in suicide ideators and attempters. Resting-state functional connectivity findings highlight reduced positive connectivity between the default mode network and salience network in attempters and show that self-injurers exhibit frontolimbic alterations. Together, suicidal and nonsuicidal behaviors are related to top-down and bottom-up neural alterations, which may compromise approach, avoidance, and regulatory systems. Future longitudinal research with larger and well-characterized samples, especially those integrating ambulatory stress assessments, will be well positioned to identify novel targets that may improve early identification and treatment for youth with STBs and NSSI.
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Affiliation(s)
- Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA,Division of Clinical Developmental Neuroscience, Sackler Institute, New York, New York, USA, Corresponding author: 1051 Riverside Drive, Pardes 2407, New York, NY 10032;
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Grace O. Allison
- Department of Psychiatry, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Kira L. Alqueza
- Department of Psychiatry, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Maria Fernanda Alonso
- Department of Psychiatry, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
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